Comments on GUIDE-IT, a randomized study of natriuretic peptide-guided therapy in high-risk patients with heart failure and reduced ejection fraction

The topic of guiding therapy in heart failure patients with natriuretic peptide levels is not new: eleven trials have been performed and several meta-analyses have been published including one with individual patient data (1). The GUIDE-IT trial should have been the trial that confirmed the meta-analyses that guiding therapy with natriuretic peptides in patients with heart failure would reduce the primary endpoint of heart failure readmissions and cardiovascular mortality by 20% (2,3).