Please select the eligibility criteria that correspond to the clinical trial below.
Title: Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure.
Brief Summary: The primary objective is to determine the efficacy of a strategy of biomarker-guided therapy compared with usual care in high risk patients with left ventricular systolic dysfunction.


Options:
A: Inclusion Criteria:

* Admission because of congestive heart failure
* Elevated NT-proBNP levels on admission

Exclusion Criteria:

* Life-threatening cardiac arrhythmias
* Urgent intervention
* Severe lung disease
* Presence of life threatening disease
* Signed informed consent for other study
* Mental or physical status not allowing written informed consent.
* Unwillingness to give informed consent
* Patients undergoing haemodialysis or continuous ambulatory peritoneal dialysis (CAPD)
B: Inclusion Criteria:

* Age \> 21 years of age
* Left ventricular ejection fraction ≤ 40%
* NYHA class II-IV heart failure
* Hospital admission, Emergency Department visit, or outpatient diuretic escalation of therapy for destabilized HF at least once in the 6 months prior to enrollment

Exclusion Criteria:

* Severe renal insufficiency defined as serum creatinine \> 2.5 mg/dl
* Inoperable aortic valvular heart disease
* Life expectancy \<1 year due to causes other than HF such as advanced cancer
* Cardiac transplantation or revascularization indicated or expected within 6 months
* Severe obstructive or restrictive pulmonary disease, defined as a forced expiratory volume in 1S \<1 L when diagnosed as standard of care.
* Subject unable or unwilling to provide written informed consent
* Coronary revascularization (PCI or CABG) within the previous 3 months
C: Inclusion Criteria:

* ≥40 Years of age
* with risk factors for LVD including:

  * hypertension (medicated for ≥ 1 month)
  * hypercholesterolemia
  * obesity
  * coronary artery disease (confirmed by angiography)
  * diabetes mellitus
  * arrhythmia
  * valvular abnormalities

Exclusion Criteria:

* failure or unwilling to provide informed consent
* known ventricular dysfunction (confirmed by angiography or echocardiography)
* previous documented episode of heart failure
D: Inclusion Criteria:

* Age 18 years or older
* Most recent LVEF to be ≤ 40% by any method within 12 months of randomization.
* High risk heart failure as defined by the following criteria:

A Heart Failure Event in the prior 12 months, defined as any one of the following:

* HF Hospitalization
* Treatment in the Emergency Department (or equivalent) for Heart Failure
* Outpatient treatment for heart failure with intravenous diuretics

AND

* NT-proBNP greater than 2000 pg/mL or BNP greater than 400 pg/mL at any time during the 30 days prior to randomization
* Willing to provide informed consent

Exclusion Criteria:

* Acute coronary syndrome (clinical diagnosis) or cardiac revascularization procedure within 30 days
* Cardiac resynchronization therapy (CRT) within prior 3 months or current plan to implant CRT device
* Active myocarditis, Hypertrophic obstructive cardiomyopathy, pericarditis, or restrictive cardiomyopathy
* Severe stenotic valvular disease
* Anticipated heart transplantation or ventricular assist device within 12 months
* Chronic inotropic therapy
* Complex congenital heart disease
* End stage renal disease with renal replacement therapy
* Non cardiac terminal illness with expected survival less than 12 months
* Women who are pregnant or planning to become pregnant
* Inability to comply with planned study procedures
* Enrollment or planned enrollment in another clinical trial

Answer: D