ISBN: 978-1-4731-3093-7 Study Intervention and comparison (in HF clinic unless stated otherwise) Population Outcomes Comments (Adlbrecht ) NP monitoring: Therapy intensified to meet or maintain target (NT-proBNP <2200pg/l), Clinical monitoring: Therapy intensified at clinician s discretion according to clinical assessment No protocol: Discharged to primary care Age mean: 71(12) Recently hospitalised with NYHA class III/IV and cardiothoracic ratio > 0.5 or LVEF HTA aggregate: Mortality by age Troughton IPD: HF admission Study papers: No monitoring arm Recruited from hospital Christchurch pilot Troughton NP monitoring: Treatment intensified to reach target (NT- Clinical monitoring: Therapy increased to reach target months Age mean: 70(10) LVEF < 40%, NYHA class II-IV Treatment with at least ACEi and loop diuretic HTA aggregate: Mortality by age Study papers: All-cause admission Hypotension Renal function Recruited in hospital or HF clinic GUIDE-IT trial: NP monitoring: titrate HF therapy to target an NT-proBNP level of < 1000 pg/mL, 12-24 months Clinical monitoring: Therapy intensified at clinician discretion according to clinical assessment based on 2013 AHA/ACC guideline, 12-24 months Age median (IQR): NP monitoring: 62 LVEF < 40%, history of HF event within the prior 12 months and an NT- proBNP level of more than 2000 pg/mL or BNP of more than 400 pg/mL within the prior 30 days All-cause mortality HF hospitalisations (count rate) Symptomatic hypotension Symptomatic bradycardia Hyperkalaemia Worsening renal function Recruited at 45 sites in the US and Canada The study was premature ly discontinu ed due to lack of efficacy (based on statistical significanc e) of evidence for the biomarker- guided treatment group compared Chronic Heart Failure Monitoring NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 Study Intervention and comparison (in HF clinic unless stated otherwise) Population Outcomes Comments with clinical monitoring Northstar trial: NP monitoring: Further investigation and treatment if months Clinical monitoring: Therapy intensified at clinician discretion according to clinical assessment, 30 months Age 18 years, LVEF 45 % Elevated NP (NT- ml) despite education on CHF and optimal ACE/ARB and BB therapy HTA IPD: Mortality by age all-cause admission by age Recruited from HF clinics OPTIMA trial: NP monitoring: Therapy intensified according to clinical status and serial BNP levels, 2 years Clinical monitoring: Therapy was intensified according to clinical status, 2 years Age limits 18-90, Recently hospitalised, NYHA III/IV and HTA: None Study papers: Mortality by age all-cause admission by age No informatio n on recruitmen t PRIMA trial: NP monitoring: therapy increased to reach or maintain target (NT-proBNP at the lowest level recorded at discharge or two weeks following), 24 months Clinical monitoring: Therapy increased at clinician s discretion according to clinical assessment, 24 months Age mean: 72(12) Recently hospitalised HF- admission, mainly NYHA III, Elevated NPs (NT- proBNP levels at admission 1700 pg/mL) that respond to treatment (decrease 10% at discharge) HTA aggregate: Mortality by age Troughton IPD: HF admission Recruited from hospital PROTECT trial: (Weiner , Mallick , Ibrahim , Bhardwaj , Bhardwaj )) NP monitoring: Therapy intensified to reach target (NT- months Clinical monitoring: Therapy intensified at clinician discretion according to clinical assessment, 6-12 months Age 21 years, NYHA class II-IV, LVEF 40%, destabilisation in (attended hospital or clinic for worsening HF) HTA: Nil Troughton IPD: HF hospitalisation Study papers: Quality of life Hypotension Recruited Chronic Heart Failure Monitoring NICE 2018. 