Evidence map›Paper›PMID 31326896›Full record

SynthesisBMJ evidence-based medicine2020

Natriuretic peptide-guided treatment for heart failure: a systematic review and meta-analysis.

Julie McLellan, Clare R Bankhead, Jason L Oke, F D Richard Hobbs, Clare J Taylor, Rafael Perera

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ evidence-based medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Sample Size of Trials Investigating the Impact of Point-of-Care Ultrasound-Guided Strategies on Patient Outcomes: A Systematic Review.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Julie McLellanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0002-2868-8631
Clare R BankheadNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Jason L OkeNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
F D Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Clare J TaylorNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Rafael PereraNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0003-2418-2091

Funding

Department of Health IS-SPC-0514-10043Medical Research Council MC_PC_11004
6 · The paper itself

Abstract

backgroundGUIDE-IT, the largest trial to date, published in August 2017, evaluating the effectiveness of natriuretic peptide (NP)-guided treatment of heart failure (HF), was stopped early for futility on a composite outcome. However, the reported effect sizes on individual outcomes of all-cause mortality and HF admissions are potentially clinically relevant.

objectiveThis systematic review and meta-analysis aims to combine all available trial level evidence to determine if NP-guided treatment of HF reduces all-cause mortality and HF admissions in patients with HF. STUDY SELECTION: Eight databases, no language restrictions, up to November 2017 were searched for all randomised controlled trials comparing NP-guided treatment versus clinical assessment alone in adult patients with HF. No language restrictions were applied. Publications were independently double screened and extracted. Fixed-effect meta-analyses were conducted.

findings89 papers were included, reporting 19 trials (4554 participants), average ages 62-80 years. Pooled risk ratio estimates for all-cause mortality (16 trials, 4063 participants) were 0.87, 95% CI 0.77 to 0.99 and 0.80, 95% CI 0.72 to 0.89 for HF admissions (11 trials, 2822 participants). Sensitivity analyses, restricted to low risk of bias, produced similar estimates, but were no longer statistically significant.

conclusionsConsidering all the evidence to date, the pooled effects suggest that NP-guided treatment is beneficial in reducing HF admissions and all-cause mortality. However, there is still insufficient high-quality evidence to make definitive recommendations on the use of NP-guided treatment in clinical practice. TRIAL REGISTRATION NUMBER: Systematic Review Cochrane Database Number: CD008966.

Indexed as

Cause of DeathEvidence-Based MedicineHeart FailureHospitalizationHumansMedical FutilityNatriuretic Peptide, BrainPeptide FragmentsNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)all-cause mortalitybiomarkerheart failureheart failure admissionmeta-analysisnatriuretic peptide

Identifiers

PMID31326896
PMCPMC7029248

What OpenQuestion holds

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Registered trials

None linked

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.