A Novel Drug Therapy for Heart Failure with Reduced Systolic Function

Adverse consequences of heart failure with reduced ejection fraction (HFrEF) remain substantial despite a robust evidence-based armamentarium that focuses on attenuating the neurohormonal activation characteristic of the syndrome. In a manufacturer-sponsored, placebo-controlled, randomized trial, researchers assessed the impact of vericiguat, a non–FDA-approved oral soluble guanylate cyclase stimulator that enhances the intracellular cyclic GMP pathway.

The 5050 participants had symptomatic HF, elevated natriuretic peptide levels, and left-ventricular ejection fraction (LVEF) below 45% (mean age, 67; 24% women; mean LVEF, 29%). All had worsening HF (i.e., hospitalization within the past 6 months or receipt of intravenous diuretics within the…