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Coronary fractional flow reserve in bifurcation stenoses: what have we learned? Coronary Artery Intraplaque Microvessels by Optical Coherence Tomography Correlate With Vulnerable Plaque and Predict Clinical Outcomes in Patients With Ischemic Angina Joint consensus on the use of OCT in coronary bifurcation lesions by the European and Japanese bifurcation clubs Management of pulmonary hypertension from left heart disease in candidates for orthotopic heart transplantation Local Low Shear Stress and Endothelial Dysfunction in Patients With Nonobstructive Coronary Atherosclerosis Classification and treatment of coronary artery bifurcation lesions: putting the Medina classification to the test Left ventricular remodelling and changes in functional measurements in patients undergoing transcatheter vs surgical aortic valve replacement: a head-to-head comparison Diagnostic accuracy of intracoronary optical coherence tomography-derived fractional flow reserve for assessment of coronary stenosis severity T and small protrusion (TAP) vs double kissing crush technique: Insights from in-vitro models ‘Small bifurcation?’ CT myocardial mass volume measurements change therapeutic strategy in coronary artery disease

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.