Efficacy of Vericiguat in patients with heart failure: A systematic review and meta- analysis of randomized controlled trials

Objective: This meta-analysis evaluates its efficacy and safety of Vericiguat, an oral soluble guanylate cyclase stimulator Methodology: A systematic search was conducted using PubMed, Scopus, and Cochrane databases through May 31, 2024. Randomized controlled trials (RCTs) comparing vericiguat to placebo in heart failure patients were included. Pooled risk ratios (RR) for cardiovascular death, heart failure hospitalization, and adverse events were calculated using a fixed-effects model. Risk of bias was assessed using the Cochrane ROB 2.0 tool. Results: Four RCTs comprising 3,564 patients were included, with overall low to unclear risk of bias. Vericiguat showed no statistically significant reduction in cardiovascular death (RR 0.90; 95% CI 0.75–1.07; p=0.23) or heart failure hospitalization (RR 0.92; 95% CI 0.85–1.01; p=0.06). Adverse event rates were similar between groups (RR 1.00; 95% CI 0.98–1.03; p=0.86). Conclusion: Vericiguat appears to be a well-tolerated treatment for heart failure; however, current evidence does not confirm significant clinical benefit in reducing cardiovascular death or hospitalizations. Further large-scale trials are warranted to clarify its therapeutic role.