SynthesisReviews in cardiovascular medicine2026
Biomarker-Guided Versus Clinically Guided Management Strategies for Heart Failure: A Systematic Review and Meta-Analysis.
Synthesis in Reviews in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The clinical value of B-type natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided therapy for improving outcomes in patients with heart failure (HF) remains controversial. Thus, this meta-analysis synthesizes the available evidence from randomized controlled trials (RCTs) to determine whether a biomarker-guided strategy reduces all-cause mortality and HF-related hospitalizations compared with clinically guided management. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted a systematic search of PubMed, Embase, the Cochrane Library, and Web of Science databases from inception to May 2025 for RCTs comparing biomarker-guided versus clinically guided management in patients with HF. Pooled risk ratios (RRs) were calculated using a random-effects model. We performed extensive supplementary analyses, including a subgroup analysis, sensitivity analysis, and trial sequential analysis (TSA). Results: We included 17 articles (reporting on 17 distinct RCTs) comprising 5069 patients. The primary meta-analysis showed that biomarker-guided therapy was associated with a significant reduction in all-cause mortality (RR 0.84, 95% confidence interval (CI) 0.73-0.96; I Conclusions: Although there is a trend toward benefit, the existing evidence for biomarker-guided HF therapy is deemed "very low" quality based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) assessment. The results were compromised by methodological deficiencies in primary studies and potential publication bias. Therefore, the evidence is inadequate to support the routine use of this strategy in clinical practice. Further large-scale, high-quality RCTs are warranted. The PROSPERO Registration: CRD420250652134, https://www.crd.york.ac.uk/PROSPERO/view/CRD420250652134.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.