Please select the eligibility criteria that correspond to the clinical trial below.
Title: Can Pro-brain-natriuretic Peptide Guided Therapy of Chronic Heart Failure Improve Heart Failure Morbidity and Mortality?
Brief Summary: The purpose of this study is to determine whether NT-proBNP guided treatment of chronic congestive heart failure will reduce heart failure related morbidity and mortality compared to therapy guided by standard clinical judgement.


Options:
A: 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
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:

* Adults (18 years of age or older);
* Admitted to the hospital or observation unit with a diagnosis of decompensated HF for which treatment will be administered;
* Blood BNP level measurement \> 400 pg/mL documented during admission; If NT-proBNP is used routinely in the laboratory at a clinical site rather than BNP, then blood NT-proBNP level measurement \> 1,600 pg/mL documented during admission.
* Successfully trained on how to perform a fingerstick and to use the Triage touch.
* Either the subject or their care provider is fluent in reading and writing English

Exclusion Criteria:

* Unwilling or unable to provide written informed consent;
* Acute coronary syndrome (ACS) that is concomitant with the diagnosis of decompensated HF and for which treatment will be provided.

A history of ACS is not reason for exclusion if it is not concomitant with the present decompensated HF for which admission is being made. Small elevations in cardiac troponin that are considered by the treating physician to be associated with myocardial injury due to the acute decompensated HF and not due to a concomitant ACS or myocardial infarction are not a basis for exclusion.

* Previous cardiac transplantation - or cardiac transplantation anticipated within 3 months;
* Current or planned use of a left ventricular assist device (LVAD), use of outpatient intravenous inotropic HF therapy, major surgical procedure or percutaneous coronary intervention within 3 months;
* Life expectancy less than 3 months due to causes other than HF or cardiovascular disease (e.g., cancer);
* End stage renal disease;
* Prisoner or other institutionalized or vulnerable individual;
* Residence in regions where either transmission of Triage Touch data or a home visit on day 5 is not possible.
* Dementia, tremors or other impediments to performing daily home BNP testing via fingerstick.
* Deemed by the Investigator not to be likely to comply with study-mandated procedures or instructions.
D: 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)

Answer: D