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Guiding Evidence Based Therapy Using Biomarker Intensified Treatment (GUIDE-IT)

This study has been terminated.
(Project was stopped due to futility)
Sponsor:
ClinicalTrials.gov Identifier:
NCT01685840
First Posted: September 14, 2012
Last Update Posted: October 19, 2017
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Collaborator:
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by (Responsible Party):
Duke University
  Purpose
The primary objective is to determine the efficacy of a strategy of biomarker-guided therapy compared with usual care in high risk patients with left ventricular systolic dysfunction.

Condition Intervention
Heart Failure Other: Usual Care Device: Biomarker-guided care NT-proBNP

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure.

Resource links provided by NLM:


Further study details as provided by Duke University:

Primary Outcome Measures:
  • Time to CV death or HF Hospitalization [ Time Frame: 12 months ]
    Time to CV death or first HF hospitalization


Secondary Outcome Measures:
  • Time to All-cause mortality [ Time Frame: 12 months ]
    Time to death

  • Cumulative Morbidity [ Time Frame: 12 months ]
    Time alive and not hospitalized for CV reasons

  • Time to Death [ Time Frame: 12 months ]
    Time to CV death

  • Time to first HF hospitalization [ Time Frame: 12 months ]
    Time to first HF hospitalization

  • Health Related Quality of Life [ Time Frame: 12 months ]
    Health related quality of life

  • Resource Utilization, cost and cost effectiveness [ Time Frame: 12 months ]
    medical costs, resource and cost effectiveness

  • Number of participants with AEs of interest and/ or SAEs [ Time Frame: 12 months ]
    Number of participants with Adverse Events of interest and/ or Serious Adverse Events.


Enrollment: 894
Study Start Date: December 2012
Study Completion Date: September 20, 2016
Primary Completion Date: September 20, 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Usual Care
Usual Care group will receive standard heart failure treatment based on the doctor's best judgment and following the recommendation of current guidelines. This will typically include the use of medicines such as beta-blockers, ACE-inhibitors, and diuretics, all of which are approved, recommended treatments for heart failure.
Other: Usual Care
Usual Care
Experimental: Biomarker-Guided Care
Device: Biomarker-Guided care NT-proBNP The Biomarker Guided Therapy group will receive the standard heart failure treatments. In addition, the doctor will use the results of a blood test called NT-proBNP to help adjust the treatments and drug doses.
Device: Biomarker-guided care NT-proBNP
Device: NT-proBNP

Detailed Description:
Heart failure is a common disorder in which the heart cannot pump enough blood to meet the needs of the rest of the body. Common symptoms of heart failure include shortness of breath, swelling, and fatigue. Standard treatment for heart failure include diuretics to control fluid, as well as drugs called "neurohormonal antagonists" (such as beta-blockers and ACE-inhibitors) that help the heart work more efficiently and prevent worsening of heart function. Typically, doctors adjust these medicines based on their clinical judgment about what doses and combination will work best for you. We are testing whether the use of a blood test called NT-proBNP (which measures a hormone released by the heart) can help doctors do a better job of adjusting these heart failure medicines over time than clinical judgment alone.
  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age 18 years or older
  • Most recent LVEF to be ≤ 40% by any method within 12 months of randomization.
  • High risk heart failure as defined by the following criteria:

A Heart Failure Event in the prior 12 months, defined as any one of the following:

  • HF Hospitalization
  • Treatment in the Emergency Department (or equivalent) for Heart Failure
  • Outpatient treatment for heart failure with intravenous diuretics

AND

  • NT-proBNP greater than 2000 pg/mL or BNP greater than 400 pg/mL at any time during the 30 days prior to randomization
  • Willing to provide informed consent

Exclusion Criteria:

  • Acute coronary syndrome (clinical diagnosis) or cardiac revascularization procedure within 30 days
  • Cardiac resynchronization therapy (CRT) within prior 3 months or current plan to implant CRT device
  • Active myocarditis, Hypertrophic obstructive cardiomyopathy, pericarditis, or restrictive cardiomyopathy
  • Severe stenotic valvular disease
  • Anticipated heart transplantation or ventricular assist device within 12 months
  • Chronic inotropic therapy
  • Complex congenital heart disease
  • End stage renal disease with renal replacement therapy
  • Non cardiac terminal illness with expected survival less than 12 months
  • Women who are pregnant or planning to become pregnant
  • Inability to comply with planned study procedures
  • Enrollment or planned enrollment in another clinical trial
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01685840


  Show 46 Study Locations
Sponsors and Collaborators
Duke University
National Heart, Lung, and Blood Institute (NHLBI)
Investigators
Principal Investigator: Michael Felker, MD Duke University