Awesome game. Hard as hell, though.
Every time you start the game all the levels are randomly generated. Each level has a treasure room which contains an item that may give a boost to your status or give you a special ability. Some items make the playthrough a lot easier, some can make it even harder. The items you get are basically down to luck.
The game is still hard anyway. There's no item that guarantees you'll win and, fortunately, there are strategies that help you make the most out of what you got. If you're good enough at the game the items may not even matter, you're just that good.
Unfortunately we don't have infinite tries at life like we do in a video game to learn how to get better. You have to learn while you play the only run you've got.
That's how I see the whole issue of luck vs. merit.