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A Combined Optical Coherence Tomography and Intravascular Ultrasound Study on Plaque Rupture, Plaque Erosion, and Calcified Nodule in Patients With ST-Segment Elevation Myocardial Infarction: Incidence, Morphologic Characteristics, and Outcomes After Percutaneous Coronary Intervention Negative Risk Markers for Cardiovascular Events in the Elderly Exercise Intolerance in Patients With Heart Failure: JACC State-of-the-Art Review Prognostic value of coronary artery calcium screening in subjects with and without diabetes Heart Failure With Recovered Left Ventricular Ejection Fraction: JACC Scientific Expert Panel The Use of Sex-Specific Factors in the Assessment of Women’s Cardiovascular Risk Impact of final stent dimensions on long-term results following sirolimus-eluting stent implantation: serial intravascular ultrasound analysis from the sirius trial Transcatheter versus Surgical Aortic Valve Replacement in Patients with Prior Cardiac Surgery in the Randomized PARTNER 2A Trial Impact of Positive and Negative Lesion Site Remodeling on Clinical Outcomes : Insights From PROSPECT Summary of Updated Recommendations for Primary Prevention of Cardiovascular Disease in Women: JACC State-of-the-Art Review
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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.

 

 


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