CBS 2019
CBSMD教育中心
中 文

充血性心力衰竭

Abstract

Recommended Article

Heart Failure Outcomes With Volume-Guided Management Natriuretic Peptide-Guided Heart Failure Therapy After the GUIDE-IT Study Primary Prevention of Heart Failure in Women A trial to evaluate the effect of the sodium-glucose co-transporter 2 inhibitor dapagliflozin on morbidity and mortality in patients with heart failure and reduced left ventricular ejection fraction (DAPA-HF) Nuclear Imaging of the Cardiac Sympathetic Nervous System: A Disease-Specific Interpretation in Heart Failure Modifiable lifestyle factors and heart failure: A Mendelian randomization study Impact of Myocardial Scar on Prognostic Implication of Secondary Mitral Regurgitation in Heart Failure Permanent pacemaker use among patients with heart failure and preserved ejection fraction: Findings from the Acute Decompensated Heart Failure National Registry (ADHERE) National Registry

Review Article2018 Apr;15(2):37-43.

JOURNAL:Curr Heart Fail Rep. Article Link

The Future of Biomarker-Guided Therapy for Heart Failure After the Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) Study

Ibrahim NE, Januzzi JL Jr. Keywords: Biomarkers; Clinical trials; Guidelines; Heart failure; Heart failure therapy; Natriuretic peptides

ABSTRACT


PURPOSE OF REVIEW - Biomarker-guided management of patients with chronic heart failure with reduced ejection fraction (HFrEF) remains controversial.

 

RECENT FINDINGS - Biomarkers have established roles for diagnosis and prognostication in HF. Pilot data suggested that use of natriuretic peptides might be helpful to guide HF care. The recent Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) randomized-controlled trial did not find therapy guided by NT-proBNP to be more effective than usual care in improving the primary endpoint of HF hospitalization or cardiovascular mortality amongst patients with chronic HFrEF. Patients inGUIDE-ITreceived similar care and had similar NT-proBNP lowering regardless of treatment allocation. Though biomarkers retain important standing for diagnosis and prognosis in HF, theGUIDE-ITtrial results suggest carefully managed patients may not benefit from a biomarker-guided strategy. Future studies focusing this intervention on patients treated in a more real-world setting are needed.