{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:35:43Z","timestamp":1791920143379,"version":"4.3.4"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,5,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">NT\u2010proBNP (N\u2010terminal pro\u2010B\u2010type natriuretic peptide) is a prognostic biomarker in heart failure (HF) with reduced ejection fraction. However, it is unclear whether there is a sex difference in NT\u2010proBNP response and whether the therapeutic goal of NT\u2010proBNP \u22641000\u00a0pg\/mL has equivalent prognostic value in men and women with HF with reduced ejection fraction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">In a secondary analysis of the GUIDE\u2010IT (Guiding Evidence Based Therapy Using Biomarker Intensified Treatment) trial we analyzed trends in NT\u2010proBNP and goal attainment by sex. Differences in clinical characteristics, HF treatment, and time to all\u2010cause death or HF hospitalization were compared. Landmark analysis at 3\u00a0months determined the prognostic value of early NT\u2010proBNP goal achievement in men and women. Of the 286 (32%) women and 608 (68%) men in the GUIDE\u2010IT trial, women were more likely to have a nonischemic cause and shorter duration of HF. Guideline\u2010directed medical therapy was less intense over time in women. The absolute NT\u2010proBNP values were consistently lower in women; however, the change in NT\u2010proBNP and clinical outcomes were similar. After adjustment, women achieving the NT\u2010proBNP goal had an 82% reduction in death or HF hospitalization compared with a 59% reduction in men.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Men and women with HF with reduced ejection fraction had a similar NT\u2010proBNP response despite less intensive HF treatment among women. However, compared with men, the early NT\u2010proBNP goal of \u22641000\u00a0pg\/mL had greater prognostic value in women. Future efforts should be aimed at intensifying guideline\u2010directed medical therapy in women, which may result in greater NT\u2010proBNP reductions and improved outcomes in women with HF with reduced ejection fraction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT01685840.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019712","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T09:17:32Z","timestamp":1620292652000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Differences in NT\u2010proBNP Response and Prognosis in Men and Women With Heart Failure With Reduced Ejection Fraction"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8485-565X","authenticated-orcid":false,"given":"Melissa A.","family":"Daubert","sequence":"first","affiliation":[{"name":"Duke University Medical Center Durham NC"},{"name":"Duke Clinical Research Institute Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Yow","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiman X.","family":"Barnhart","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Durham NC"},{"name":"Duke Clinical Research Institute Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4986-7129","authenticated-orcid":false,"given":"Ileana L.","family":"Pi\u00f1a","sequence":"additional","affiliation":[{"name":"Wayne State University Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariq","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Yale School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Leifer","sequence":"additional","affiliation":[{"name":"National Heart, Lung and Blood Institute Bethesda MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9704-8777","authenticated-orcid":false,"given":"Lawton","family":"Cooper","sequence":"additional","affiliation":[{"name":"National Heart, Lung and Blood Institute Bethesda MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1073-641X","authenticated-orcid":false,"given":"Patrice","family":"Desvigne\u2010Nickens","sequence":"additional","affiliation":[{"name":"National Heart, Lung and Blood Institute Bethesda MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Fiuzat","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirkwood","family":"Adams","sequence":"additional","affiliation":[{"name":"University of North Carolina Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2724-4086","authenticated-orcid":false,"given":"Justin","family":"Ezekowitz","sequence":"additional","affiliation":[{"name":"University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Whellan","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8338-1798","authenticated-orcid":false,"given":"James L.","family":"Januzzi","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"O\u2019Connor","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Durham NC"},{"name":"Inova Heart and Vascular Institute Falls Church VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5931-1239","authenticated-orcid":false,"given":"G. Michael","family":"Felker","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Durham NC"},{"name":"Duke Clinical Research Institute Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11936-018-0687-y"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2020.12.025"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.09.081"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.05.012"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.03.011"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2017.07.011"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.3724\/SP.J.1263.2011.00015"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.22917"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.07.012"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.119.006134"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2013.10.007"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.06.1162"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.3.375"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.180177"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-014-0786-z"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-16-1345"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-18-0375"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.10565"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2014.05.007"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.06.055"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/heart.89.7.745"},{"key":"e_1_3_1_23_2","first-page":"3","volume-title":"Handbook of Statistics","author":"Neves J","year":"2019","unstructured":"Neves J, Dufour JM. Handbook of Statistics. London, England: Elsevier; 2019:ch 1:3\u201331."},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.0640"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.070"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-9842(99)00053-7"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-016-9575-2"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.030526"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2013.11.007"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409077"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.044491"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.019712","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:05:01Z","timestamp":1715598301000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.019712"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,18]]},"references-count":30,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,5,18]]}},"alternative-id":["10.1161\/JAHA.120.019712"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.019712","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,18]]},"assertion":[{"value":"2021-01-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e019712"}}