eISSN: 2345-4202  
J Nephropharmacol. 2018;7(2):66-67.

Epidemiology and Prevention

The guiding evidence based therapy using biomarker intensified treatment in heart failure (GUIDE-IT) study; the utility of decongestive diuresis in type 1 cardiorenal syndrome with rising pro-BNP levels 

Macaulay Amechi Chukwukadibia Onuigbo 1,2,3 *

1 Mayo Clinic College of Medicine, Rochester, MN, USA
2 Department of Nephrology, Mayo Clinic Health System, Eau Claire, WI, USA
3 College of Business, University of Wisconsin MBA Consortium, Wisconsin, USA
*Corresponding author: Macaulay Amechi Onuigbo, Email: Email: onuigbo.macaulay@mayo.edu

Implication for health policy/practice/research/medical education:

The Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) study, a randomized clinical trial of nearly 1000 patients with heart failure and reduced ejection fraction, compared amino-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided treatment strategy versus usual care. The study failed to show any differences in the primary end point of the composite of time-to-first heart failure hospitalization or cardiovascular mortality. Remarkably, despite the proBNPguided titration in the intervention group, there were no significant differences in medical therapy over time, between the two groups in relation to percentage exposure to the ACEI/ARB at 12 months. We had recently shown in a small case series that rising BNP levels at presentation in patients with type 1 cardiorenal syndrome portended improved cardiorenal outcomes as well as responsiveness to combination diuretics or decongestive diuresis. Further larger studies of these observations are warranted.

Please cite this paper as: Onuigbo MAC. The guiding evidence based therapy using biomarker intensified treatment in heart failure (GUIDE-IT) study; the utility of decongestive diuresis in type 1 cardiorenal syndrome with rising pro-BNP levels. J Nephropharmacol. 2018;7(2):66-67. 

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Submitted: 10 Oct 2018

Accepted: 09 Dec 2017
First published online: 31 Dec 2017
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