Trial reportJournal of the American College of Cardiology2018
Economic and Quality-of-Life Outcomes of Natriuretic Peptide-Guided Therapy for Heart Failure.
Trial report in Journal of the American College of Cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01685840 (Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure.), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- A Systematic Review of Medical Costs Associated with Heart Failure in the USA (2014-2020).PharmacoEconomics · 2020Pooled it
- Heart Failure With Mildly Reduced Ejection Fraction: A Heart Failure Society of America Scientific Statement.Journal of cardiac failure · 2026Review
- Cell-Free DNA Profiles End-Organ Injury and Predicts Outcomes in Advanced Heart Failure With Left Ventricular Assist Device Implantation.Circulation. Heart failure · 2026Observational
- The effects of frailty, mental health, and cardiac function on quality of life in patients undergoing transcatheter aortic valve replacement.Scientific reports · 2025Article
- The Role of Natriuretic Peptides in the Management of Heart Failure with a Focus on the Patient with Diabetes.Journal of clinical medicine · 2024Review
- Disparities in Patient Portal Engagement Among Patients With Hypertension Treated in Primary Care.JAMA network open · 2024Article
- Economic Issues in Heart Failure in the United States.Journal of cardiac failure · 2022Review
- Biomarkers for the diagnosis and management of heart failure.Heart failure reviews · 2022Review
- The Impact of Clinical, Biochemical, and Echocardiographic Parameters on the Quality of Life in Patients with Heart Failure with Reduced Ejection Fraction.International journal of environmental research and public health · 2021Article
- Effects of Atrial Fibrillation on Heart Failure Outcomes and NT-proBNP Levels in the GUIDE-IT Trial.Mayo Clinic proceedings. Innovations, quality & outcomes · 2021Article
- Targeting Natriuretic Peptide Levels in Heart Failure with Therapy: Does "X" Really Mark the Spot?Current heart failure reports · 2019Review
Corrections and comments
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Authors and funding
17 authors at 10 institutions in 2 countries.
Funding
Abstract
backgroundThe GUIDE-IT (GUIDing Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure) trial prospectively compared the efficacy of an N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided heart failure treatment strategy (target NT-proBNP level <1,000 pg/ml) with optimal medical therapy alone in high-risk patients with heart failure and reduced ejection fraction. When the study was stopped for futility, 894 patients had been enrolled.
objectivesThe purpose of this study was to assess treatment-related quality-of-life (QOL) and economic outcomes in the GUIDE-IT trial.
methodsThe authors prospectively collected a battery of QOL instruments at baseline and 3, 6, 12, and 24 months post-randomization (collection rates 90% to 99% of those eligible). The principal pre-specified QOL measures were the Kansas City Cardiomyopathy Questionnaire (KCCQ) Overall Summary Score and the Duke Activity Status Index (DASI). Cost data were collected for 735 (97%) U.S. PATIENTS:
resultsBaseline variables were well balanced in the 446 patients randomized to the NT-proBNP-guided therapy and 448 to usual care. Both the KCCQ and the DASI improved over the first 6 months, but no evidence was found for a strategy-related difference (mean difference [biomarker-guided - usual care] at 24 months of follow-up 2.0 for DASI [95% confidence interval (CI): -1.3 to 5.3] and 1.1 for KCCQ [95% CI: -3.7 to 5.9]). Total winsorized costs averaged $5,919 higher in the biomarker-guided strategy (95% CI: -$1,795, +$13,602) over 15-month median follow-up.
conclusionsA strategy of NT-proBNP-guided HF therapy had higher total costs and was not more effective than usual care in improving QOL outcomes in patients with heart failure and a reduced ejection fraction. (Guiding Evidence Based Therapy Using Biomarker Intensified Treatment [GUIDE-IT]; NCT01685840).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.