Key result
Adding vericiguat to standard therapy in patients with HFrEF significantly reduced the risk of cardiovascular death or HF hospitalization by 10% (NNT 24).
Why the study?
Many patients with HFrEF do not receive or tolerate recommended disease-modifying drugs at target doses due to clinical parameters such as blood pressure, heart rate, renal function, or potassium.
Does adding vericiguat to standard therapy reduce cardiovascular death or heart failure hospitalization in patients with HFrEF?
Does adding vericiguat to standard therapy reduce cardiovascular death or heart failure hospitalization in patients with HFrEF?
Vericiguat provides an effective treatment option for HFrEF that reduces cardiovascular death and HF hospitalization without adversely affecting heart rate, renal function, or potassium levels.
Highlights impaired NO-sGC-cGMP pathway in HFrEF; leaves open vericiguat's real-world prognostic value.
The pathophysiology of heart failure with reduced ejection fraction (HFrEF) is a complex process in which a number of neurohormonal systems are involved. Targeting only some of these systems, but not all, translates into a partial benefit of HF treatment. The nitric oxide-soluble guanylate cyclase (sGC)-cGMP pathway is impaired in HF, leading to cardiac, vascular and renal disturbances. Vericiguat is a once-daily oral stimulator of sGC that restores this system. No other disease-modifying HF drugs act on this system. Despite guidelines recommendations, a substantial proportion of patients are not taking all recommended drugs or when taking them, they do so at low doses, limiting their potential benefits. In this context, treatment should be optimized considering different parameters, such as blood pressure, heart rate, renal function, or potassium, as they may interfere with their implementation at the recommended doses. The VICTORIA trial showed that adding vericiguat to standard therapy in patients with HFrEF significantly reduced the risk of cardiovascular death or HF hospitalization by 10% (NNT 24). Furthermore, vericiguat does not interfere with heart rate, renal function or potassium, making it particularly useful for improving the prognosis of patients with HFrEF in specific settings and clinical profiles.
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Escobar et al. (2023) conducted a review in Heart failure with reduced ejection fraction (HFrEF). Vericiguat vs. standard therapy was evaluated on Cardiovascular death or HF hospitalization (10% risk reduction). Adding vericiguat to standard therapy in patients with HFrEF significantly reduced the risk of cardiovascular death or HF hospitalization by 10% (NNT 24).
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