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

被引：28
作者：
Ibrahim N.E. [1 ,2 ]
Januzzi J.L., Jr. [1 ,2 ,3 ]
机构：
[1] Cardiology Division, Massachusetts General Hospital, 55 Fruit Street, GRB-800, Boston, 02114, MA
[2] Harvard Medical School, Boston, MA
[3] Baim Institute for Clinical Research, Boston, MA
来源：
Current Heart Failure Reports | 2018年 / 15卷 / 2期
关键词：
Biomarkers; Clinical trials; Guidelines; Heart failure; Heart failure therapy; Natriuretic peptides;
D O I：
10.1007/s11897-018-0381-0
中图分类号：
学科分类号：
摘要：
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 in GUIDE-IT received similar care and had similar NT-proBNP lowering regardless of treatment allocation. Summary: 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. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
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页码：37 / 43
页数：6
相关论文
共 31 条
  • [1] Yancy C.W., Jessup M., Bozkurt B., Et al., ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure, J Am Coll Cardiol, 70, pp. 776-803, (2017)
  • [2] Januzzi J.L., Troughton R., Are serial BNP measurements useful in heart failure management?: Serial natriuretic peptide measurements are useful in heart failure management, Circulation, 127, pp. 500-508, (2013)
  • [3] Desai A.S., Are serial BNP measurements useful in heart failure management?: Serial natriuretic peptide measurements are not useful in heart failure management: the art of medicine remains long, Circulation, 127, pp. 509-516, (2013)
  • [4] Fruhwald F.M., Fahrleitner-Pammer A., Berger R., Leyva F., Freemantle N., Erdmann E., Gras D., Kappenberger L., Tavazzi L., Daubert J.C., Cleland J.G.F., Early and sustained effects of cardiac resynchronization therapy on N-terminal pro-B-type natriuretic peptide in patients with moderate to severe heart failure and cardiac dyssynchrony, Eur Heart J, 28, pp. 1592-1597, (2007)
  • [5] Tsutamoto T., Wada A., Maeda K., Mabuchi N., Hayashi M., Tsutsui T., Ohnishi M., Sawaki M., Fujii M., Matsumoto T., Matsui T., Kinoshita M., Effect of spironolactone on plasma brain natriuretic peptide and left ventricular remodeling in patients with congestive heart failure, J Am Coll Cardiol, 37, pp. 1228-1233, (2001)
  • [6] Frantz R.P., Olson L.J., Grill D., Moualla S.K., Nelson S.M., Nobrega T.P., Hanna R.D., Backes R.J., Mookadam F., Heublein D., Bailey K.R., Burnett J.C., Carvedilol therapy is associated with a sustained decline in brain natriuretic peptide levels in patients with congestive heart failure, Am Heart J, 149, pp. 541-547, (2005)
  • [7] McMurray J.J.V., Packer M., Desai A.S., Gong J., Lefkowitz M.P., Rizkala A.R., Rouleau J.L., Shi V.C., Solomon S.D., Swedberg K., Zile M.R., Angiotensin–neprilysin inhibition versus enalapril in heart failure, N Engl J Med, 371, pp. 993-1004, (2014)
  • [8] Januzzi J.J.L., Rehman S.U., Mohammed A.A., Et al., Use of amino-terminal pro-B-type natriuretic peptide to guide outpatient therapy of patients with chronic left ventricular systolic dysfunction, J Am Coll Cardiol, 58, pp. 1881-1889, (2011)
  • [9] Troughton R.W., Frampton C.M., Brunner-La Rocca H.-P., Et al., Effect of B-type natriuretic peptide-guided treatment of chronic heart failure on total mortality and hospitalization: an individual patient meta-analysis, Eur Heart J, 35, pp. 1559-1567, (2014)
  • [10] Weiner R.B., Baggish A.L., Chen-Tournoux A., Marshall J.E., Gaggin H.K., Bhardwaj A., Mohammed A.A., Rehman S.U., Barajas L., Barajas J., Gregory S.A., Moore S.A., Semigran M.J., Januzzi J.L., Improvement in structural and functional echocardiographic parameters during chronic heart failure therapy guided by natriuretic peptides: mechanistic insights from the ProBNP Outpatient Tailored Chronic Heart Failure (PROTECT) study, Eur J Heart Fail, 15, pp. 342-351, (2013)
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