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

Current Heart Failure Reports
Nasrien Ibrahim, James L Januzzi

Abstract

Biomarker-guided management of patients with chronic heart failure with reduced ejection fraction (HFrEF) remains controversial. 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 in GUIDE-IT received similar care and had similar NT-proBNP lowering regardless of treatment allocation. Though biomarkers retain important standing for diagnosis and prognosis in HF, the GUIDE-IT trial 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.

References

Sep 19, 2000·Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology·R Latini, S Masson
Apr 24, 2007·Journal of the American College of Cardiology·Patrick JourdainYves Juillière
Feb 12, 2008·European Heart Journal·Domingo A Pascual-FigalAntoni Bayes-Genis
Aug 25, 2009·American Heart Journal·G Michael FelkerChristopher M O'Connor
Sep 2, 2014·The New England Journal of Medicine·John J V McMurrayUNKNOWN PARADIGM-HF Investigators and Committees
Dec 3, 2016·Journal of the American College of Cardiology·Michael R ZileScott D Solomon

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Citations

Jun 22, 2019·European Journal of Heart Failure·Christian MuellerUNKNOWN Heart Failure Association of the European Society of Cardiology
May 31, 2019·International Journal of Molecular Sciences·Daniela Maria TanaseMariana Floria
Oct 26, 2018·Circulation Research·Nasrien E Ibrahim, James L Januzzi
Mar 13, 2019·Lancet·Patrick RossignolFaiez Zannad
Apr 15, 2021·Heart Failure Reviews·Vincenzo CastiglioneMichele Emdin

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