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

This study is currently recruiting participants. (see Contacts and Locations)
Verified January 2016 by Duke University
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by (Responsible Party):
Duke University Identifier:
First received: September 12, 2012
Last updated: March 7, 2016
Last verified: January 2016
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
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: 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 ] [ Designated as safety issue: No ]
    Time to CV death or first HF hospitalization

Secondary Outcome Measures:
  • Time to All-cause mortality [ Time Frame: 12 months ] [ Designated as safety issue: No ]
    Time to death

  • Cumulative Morbidity [ Time Frame: 12 months ] [ Designated as safety issue: No ]
    Time alive and not hospitalized for CV reasons

  • Time to Death [ Time Frame: 12 months ] [ Designated as safety issue: No ]
    Time to CV death

  • Time to first HF hospitalization [ Time Frame: 12 months ] [ Designated as safety issue: No ]
    Time to first HF hospitalization

  • Health Related Quality of Life [ Time Frame: 12 months ] [ Designated as safety issue: No ]
    Health related quality of life

  • Resource Utilization, cost and cost effectiveness [ Time Frame: 12 months ] [ Designated as safety issue: No ]
    medical costs, resource and cost effectiveness

  • Number of participants with AEs of interest and/ or SAEs [ Time Frame: 12 months ] [ Designated as safety issue: No ]
    Number of participants with Adverse Events of interest and/ or Serious Adverse Events.

Estimated Enrollment: 1100
Study Start Date: December 2012
Estimated Study Completion Date: December 2017
Estimated Primary Completion Date: September 2017 (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.

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

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


  • 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
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01685840

Contact: Gayle Paynter, RN, MBA 919-668-8641

  Show 48 Study Locations
Sponsors and Collaborators
Duke University
National Heart, Lung, and Blood Institute (NHLBI)
Principal Investigator: Michael Felker, MD Duke University
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Duke University Identifier: NCT01685840     History of Changes
Other Study ID Numbers: Pro00033097 
Study First Received: September 12, 2012
Last Updated: March 7, 2016
Health Authority: United States: Federal Government
United States: Food and Drug Administration

Keywords provided by Duke University:
Heart Failure

Additional relevant MeSH terms:
Heart Failure
Cardiovascular Diseases
Heart Diseases processed this record on May 26, 2016