Biomarker-Guided Heart Failure Therapy Results In Significant Reverse Left Ventricular Remodeling Among Patients Achieving Nt-Probnp Goal: Insights From The Guide-It Trial

Introduction: Heart failure (HF) treatment resulting in lower natriuretic peptides, such as NT-proBNP, is associated with improved clinical outcomes. Hypothesis: Achieving a NT-proBNP goal of u003c1000 pg/ml by 1 year among patients with heart failure with reduced ejection fraction (HFrEF) will result in greater reverse left ventricular (LV) remodeling compared to those who do not reach goal. Methods: The Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) Trial randomized 894 HFrEF patients (EF≤40%) to biomarker-guided therapy or usual care. Of these, 266 patients were enrolled in the Echo Substudy prior to early trial cessation. Mean follow-up was 18.7 months. Paired echocardiograms at baseline and 1 year were available in 116 patients. Differences were assessed using Wilcoxon rank sum tests. A landmark analysis of death or HF hospitalization after 12 months was performed. Results: At 1 year, 52 patients achieved NT-proBNP goal u003c1000 pg/ml (mean 428±285 pg/ml) an...