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NCT03387813: GUIDE-HF

Hemodynamic-GUIDEd Management of Heart Failure

Completed NA Results posted Last updated 7 August 2025
What this trial tests

NA trial testing CardioMEMS™ HF System in Heart Failure in 2,358 participants. Completed in 17 May 2023.

Timeline
15 March 2018
Primary endpoint
17 May 2023
17 May 2023

Quick facts

Lead sponsorAbbott Medical Devices
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposetreatment
Enrollment2,358
Start date15 March 2018
Primary completion17 May 2023
Estimated completion17 May 2023
Sites129 locations across Canada, United States

Drugs / interventions tested

Conditions studied

Sponsor

Abbott Medical Devices — full company profile →

Who can join

18 and older, any sex, with Heart Failure or Heart Failure, Systolic. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

(Randomized Arm) Composite Outcome of (1) HFHs, (2) Intravenous Diuretic Visits, and (3) All-cause Mortality Primary · 12 months post-implantation (395 days after implant date)

The composite of: 1. The number of recurrent heart failure hospitalizations (HFHs) 2. The number of heart failure (HF) emergency department/hospital outpatient observation visits for intravenous diuretic therapy (ED/OP) 3. The number of deaths of any cause added together with equal weighting into a total number of events

GroupValue95% CI
Randomized Arm - Treatment Group0.563
Randomized Arm - Control Group0.640
(Randomized Arm) Composite Outcome of (1) HFHs, (2) Intravenous Diuretic Visits, and (3) All-cause Mortality [Follow-up Based COVID-19 Sensitivity Analysis] Primary · The COVID-19 pandemic occurred during follow-up after enrollment of all subjects. Events were analyzed through March 13, 2020 for pre-COVID-19 (median follow-up: 8.4 months) and after March 13, 2020 for during COVID-19 (median follow-up: 5.2 months).

The composite of: 1. The number of recurrent heart failure hospitalizations (HFHs) 2. The number of heart failure (HF) emergency department/hospital outpatient observation visits for intravenous diuretic therapy (ED/OP) 3. The number of deaths of any cause added together with equal weighting into a total number of events.

GroupValue95% CI
Randomized Arm - Treatment Group [Pre-COVID-19]0.553
Randomized Arm - Control Group [Pre-COVID-19]0.682
Randomized Arm - Treatment Group [During COVID-19]0.597
Randomized Arm - Control Group [During COVID-19]0.536
(Randomized Arm) Composite Outcome of (1) HFHs, (2) Intravenous Diuretic Visits, and (3) All-cause Mortality [Subject Based COVID-19 Sensitivity Analysis] Primary · 12 Months Post Implantation

The composite of: 1. The number of recurrent heart failure hospitalizations (HFHs) 2. The number of heart failure (HF) emergency department/hospital outpatient observation visits for intravenous diuretic therapy (ED/OP) 3. The number of deaths of any cause added together with equal weighting into a total number of events.

GroupValue95% CI
Randomized Arm - Treatment Group (Pre-COVID-19)0.710
Randomized Arm - Control Group (Pre-COVID-19)0.864
Randomized Arm - Treatment Group (During COVID-19)0.508
Randomized Arm - Control Arm (During COVID-19)0.539
(Randomized Arm) Composite Outcome of (1) HFHs, (2) Intravenous Diuretic Visits, and (3) All-cause Mortality [Event Based COVID-19 Sensitivity Analysis] Primary · 12 Months Post-Implantation

The composite of: 1. The number of recurrent heart failure hospitalizations (HFHs) 2. The number of heart failure (HF) emergency department/hospital outpatient observation visits for intravenous diuretic therapy (ED/OP) 3. The number of deaths of any cause added together with equal weighting into a total number of events.

GroupValue95% CI
Randomized Arm - Treatment Group [Excluding COVID-19 Related Events]0.563
Randomized Arm - Control Group [Excluding COVID-19 Related Events]0.633
Randomized Arm - Treatment Group [Excluding COVID-19 Related or Possibly Related Events]0.558
Randomized Arm - Control Group [Excluding COVID-19 Related or Possibly Related Events]0.619
(Single Arm) Composite Outcome of (1) HFHs, (2) Intravenous Diuretic Visits, and (3) All-cause Mortality Primary · 12 months post-implantation (395 days after implant date)

The composite outcome of: 1. The number of recurrent heart failure hospitalizations (HFHs) 2. The number of emergency department/hospital outpatient observation visits for intravenous diuretic therapy 3. The number of deaths of any cause added together with equal weighting into a total number of events

GroupValue95% CI
Single Arm - Elevated NT-proBNP/BNP Only0.394
Single Arm - Previous HF Hospitalization Only0.771
(Single Arm) Composite Outcome of (1) HFHs, (2) Intravenous Diuretic Visits, and (3) All-cause Mortality [Follow-up Based COVID-19 Sensitivity Analysis] Primary · Events were analyzed through March 13, 2020 for pre-COVID-19 analysis (median follow-up: 5.4 months) and from March 13, 2020 through the end of subject's follow-up for during COVID-19 analysis (median follow-up: 11.2 months).

The composite outcome of: 1. The number of recurrent heart failure hospitalizations (HFHs) 2. The number of emergency department/hospital outpatient observation visits for intravenous diuretic therapy 3. The number of deaths of any cause added together with equal weighting into a total number of events

GroupValue95% CI
Single Arm - Elevated NT-proBNP/BNP Only [Prior to COVID-19]0.263
Single Arm - Previous HF Hospitalization Only [Prior to COVID-19]0.861
Single Arm - Elevated NT-proBNP/BNP Only [During COVID-19]0.418
Single Arm - Previous HF Hospitalization Only [During COVID-19]0.744
(Single Arm) Composite Outcome of (1) HFHs, (2) Intravenous Diuretic Visits, and (3) All-cause Mortality [Subject Based COVID-19 Sensitivity Analysis] Primary · 12 Months Post Implantation

The composite outcome of: 1. The number of recurrent heart failure hospitalizations (HFHs) 2. The number of emergency department/hospital outpatient observation visits for intravenous diuretic therapy 3. The number of deaths of any cause added together with equal weighting into a total number of events

GroupValue95% CI
Single Arm - Elevated NT-proBNP/BNP Only (Pre-COVID-19)0.582
Single Arm - Previous HF Hospitalization Only (Pre-COVID-19)1.853
Single Arm - Elevated NT-proBNP/BNP Only (During COVID-19)0.391
Single Arm - Previous HF Hospitalization Only (During COVID-19)0.698
(Single Arm) Composite Outcome of (1) HFHs, (2) Intravenous Diuretic Visits, and (3) All-cause Mortality [Event Based COVID-19 Sensitivity Analysis] Primary · 12 Months Post Implantation

The composite outcome of: 1. The number of recurrent heart failure hospitalizations (HFHs) 2. The number of emergency department/hospital outpatient observation visits for intravenous diuretic therapy 3. The number of deaths of any cause added together with equal weighting into a total number of events

GroupValue95% CI
Single Arm - Elevated NT-proBNP/BNP Only [Exclude COVID-19 Related Events]0.381
Single Arm - Previous HF Hospitalization Only [Exclude COVID-19 Related Events]0.746
Single Arm - Elevated NT-proBNP/BNP Only [Exclude COVID-19 Related or Possibly Related Events]0.377
Single Arm - Previous HF Hospitalization Only [Exclude COVID-19 Related or Possibly Related Events]0.737
(Randomized Arm) Composite Outcome of (1) HFHs and (2) Intravenous Diuretic Visits Secondary · 12 months post-implantation

The composite outcome of: 1. The number of recurrent heart failure hospitalizations (HFHs) 2. The number of emergency department/hospital outpatient observation visits (ED/OP) for intravenous diuretic therapy added together with equal weighting into a total number of events

GroupValue95% CI
Randomized Arm - Treatment Group0.474
Randomized Arm - Control Group0.557
(Randomized Arm) Composite Outcome of (1) HFHs and (2) Intravenous Diuretic Visits [Follow-up Based COVID-19 Sensitivity Analysis) Secondary · The COVID-19 pandemic occurred during follow-up after enrollment of all subjects. Events were analyzed through March 13, 2020 for pre-COVID-19 (median follow-up: 8.4 months) and after March 13, 2020 for during COVID-19 (median follow-up: 5.2 months).

The composite outcome of: 1. The number of recurrent heart failure hospitalizations (HFHs) 2. The number of emergency department/hospital outpatient observation visits (ED/OP) for intravenous diuretic therapy added together with equal weighting into a total number of events

GroupValue95% CI
Randomized Arm - Treatment Group [Pre-COVID-19]0.450
Randomized Arm - Control Group [Pre-COVID-19]0.595
Randomized Arm - Treatment Group [During COVID-19]0.539
Randomized Arm - Control Group [During COVID-19]0.455
(Randomized Arm) Composite Outcome of (1) HFHs and (2) Intravenous Diuretic Visits [Subject Based COVID-19 Sensitivity Analysis) Secondary · 12 Months Post Implantation

The composite outcome of: 1. The number of recurrent heart failure hospitalizations (HFHs) 2. The number of emergency department/hospital outpatient observation visits (ED/OP) for intravenous diuretic therapy added together with equal weighting into a total number of events

GroupValue95% CI
Randomized Arm - Treatment Group (Pre-COVID-19)0.529
Randomized Arm - Control Group (Pre-COVID-19)0.729
Randomized Arm - Treatment Group (During COVID-19)0.465
Randomized Arm - Control Arm (During COVID-19)0.488
(Randomized Arm) Composite Outcome of (1) HFHs and (2) Intravenous Diuretic Visits [Event Based COVID-19 Sensitivity Analysis) Secondary · 12 Months Post Implantation

The composite outcome of: 1. The number of recurrent heart failure hospitalizations (HFHs) 2. The number of emergency department/hospital outpatient observation visits (ED/OP) for intravenous diuretic therapy added together with equal weighting into a total number of events

GroupValue95% CI
Randomized Arm - Treatment Group [Excluding COVID-19 Related Events]0.474
Randomized Arm - Control Group [Excluding COVID-19 Related Events]0.551
Randomized Arm - Treatment Group [Excluding COVID-19 Related or Possibly Related Events]0.472
Randomized Arm - Control Group [Excluding COVID-19 Related or Possibly Related Events]0.545

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse device effects (ADEs), serious adverse device effects (SADEs), serious adverse events (SAEs), and unanticipated adverse device effects (UADEs) were summarized for subjects enrolled in this trial as number of events, the number and percentage of subjects with events and event rate as number of events/subject-month. Adverse event data were collected during the 1-year follow-up period.. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Randomized Arm - Treatment Group
Serious: 283/497 (57%)
Deaths: 40/497
Randomized Arm - Control Group
Serious: 272/503 (54%)
Deaths: 37/503
Single Arm
Serious: 820/1358 (60%)
Deaths: 190/1358

Serious adverse events (397 terms)

ReactionSystemRandomized Arm - Treatment…Randomized Arm - Control G…Single Arm
Cardiac Failure CongestiveCardiac disorders
ArrhythmiaCardiac disorders
InfectionInfections and infestations
Renal Failure AcuteRenal and urinary disorders
PneumoniaInfections and infestations
Gastrointestinal HemorrhageGastrointestinal disorders
SepsisInfections and infestations
Blood Creatinine IncreasedInjury, poisoning and procedural complications
Chronic Obstructive Pulmonary DiseaseRespiratory, thoracic and mediastinal disorders
HypotensionVascular disorders
AnemiaBlood and lymphatic system disorders
Chest PainGeneral disorders
Myocardial InfarctionCardiac disorders
Corona Virus InfectionInfections and infestations
Acute Respiratory FailureRespiratory, thoracic and mediastinal disorders
Non-Cardiac Chest PainGeneral disorders
SyncopeNervous system disorders
FallInjury, poisoning and procedural complications
HyperkalemiaMetabolism and nutrition disorders
Cerebrovascular AccidentNervous system disorders
HyperglycemiaMetabolism and nutrition disorders
DehydrationMetabolism and nutrition disorders
Cardiac ArrestCardiac disorders
AstheniaGeneral disorders
Unknown Event Leading to DeathGeneral disorders
Other adverse events (21 terms — click to expand)

ReactionSystemRandomized Arm - Treatment…Randomized Arm - Control G…Single Arm
Catheter Site HemorrhageGeneral disorders
Device DislocationGeneral disorders
ArrhythmiaCardiac disorders
Catheter Site HematomaGeneral disorders
HemoptysisRespiratory, thoracic and mediastinal disorders
Device Information Output IssueGeneral disorders
Device MalfunctionGeneral disorders
HypotensionVascular disorders
Catheter Site PainGeneral disorders
Device Deployment IssueGeneral disorders
PyrexiaGeneral disorders
Vessel Puncture Site PainGeneral disorders
Arterial InjuryInjury, poisoning and procedural complications
LacerationInjury, poisoning and procedural complications
PresyncopeNervous system disorders
Cardiac Failure CongestiveCardiac disorders
NauseaGastrointestinal disorders
Vascular Access ComplicationInjury, poisoning and procedural complications
Vascular PseudoaneurysmInjury, poisoning and procedural complications
SyncopeNervous system disorders
AgitationPsychiatric disorders

Most-reported serious reactions: Cardiac Failure Congestive, Arrhythmia, Infection, Renal Failure Acute, Pneumonia, Gastrointestinal Hemorrhage, Sepsis, Blood Creatinine Increased.

Data from ClinicalTrials.gov NCT03387813 adverse events section.

Sponsor's own description

The GUIDE-HF IDE clinical trial is intended to demonstrate the effectiveness of the CardioMEMS™ HF System in an expanded patient population including heart failure (HF) patients outside of the present indication, but at risk for future HF events or mortality.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial.
    Lindenfeld J, Zile MR, Desai AS, Bhatt K, et al · · 2021 · cited 304× · PMID 34461042 · DOI 10.1016/s0140-6736(21)01754-2
  2. Clinical Implications of the New York Heart Association Classification.
    Caraballo C, Desai NR, Mulder H, Alhanti B, et al · · 2019 · cited 219× · PMID 31771438 · DOI 10.1161/jaha.119.014240
  3. Remote Management of Heart Failure: An Overview of Telemonitoring Technologies.
    Brahmbhatt DH, Cowie MR. · · 2019 · cited 86× · PMID 31179018 · DOI 10.15420/cfr.2019.5.3
  4. Therapeutic approaches in heart failure with preserved ejection fraction: past, present, and future.
    Wintrich J, Kindermann I, Ukena C, Selejan S, et al · · 2020 · cited 76× · PMID 32236720 · DOI 10.1007/s00392-020-01633-w
  5. Decreases in acute heart failure hospitalizations during COVID-19.
    Cox ZL, Lai P, Lindenfeld J. · · 2020 · cited 55× · PMID 32469132 · DOI 10.1002/ejhf.1921
  6. Association of Ambulatory Hemodynamic Monitoring of Heart Failure With Clinical Outcomes in a Concurrent Matched Cohort Analysis.
    Abraham J, Bharmi R, Jonsson O, Oliveira GH, et al · · 2019 · cited 49× · PMID 31090869 · DOI 10.1001/jamacardio.2019.1384
  7. Hemodynamically-Guided Management of Heart Failure Across the Ejection Fraction Spectrum: The GUIDE-HF Trial.
    Zile MR, Mehra MR, Ducharme A, Sears SF, et al · · 2022 · cited 41× · PMID 36456066 · DOI 10.1016/j.jchf.2022.08.012
  8. The GUIDE-HF trial of pulmonary artery pressure monitoring in heart failure: impact of the COVID-19 pandemic.
    Zile MR, Desai AS, Costanzo MR, Ducharme A, et al · · 2022 · cited 32× · PMID 35266003 · DOI 10.1093/eurheartj/ehac114

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