The GUIDE-IT ( Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure ) study is designed to determine the safety , efficacy , and cost-effectiveness of a strategy of adjusting therapy with the goal of achieving and maintaining a target N-terminal pro-B-type natriuretic peptide ( NT-proBNP ) level of < @,@ pg/ml compared with usual care in high-risk patients with systolic heart failure ( HF ) .