When to Choose Vericiguat for Heart Failure with Reduced Ejection Fraction

Clinical Takeaway

: Vericiguat helped patients with worsening heart failure but not those with less-severe illness.

Context

In 2021, the U.S. FDA approved vericiguat for patients with heart failure with reduced ejection fraction (HFrEF) after VICTORIA researchers found that the soluble guanylate cyclase stimulator lowered the risk for cardiovascular death or HF hospitalization in patients with a recent decompensation (i.e., HF hospitalization within 6 months or receipt of outpatient intravenous diuretics within 3 months). Investigators further explore this therapy’s effectiveness in two manufacturer-sponsored studies.

Key Results

VICTOR was a placebo-controlled trial of vericiguat in ≈6000 ambulatory patients with HFrEF but without a recent HF event. Rates of guideline-based drug and device therapy were high. Vericiguat did not reduce time to cardiovascular…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, MACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)