Vericiguat in Chinese Patients with Heart Failure and Reduced Ejection Fraction: A Real-World Prospective Study

INTRODUCTION: Vericiguat has been shown to improve clinical outcomes in patients with heart failure (HF) with reduced ejection fraction in several randomized controlled trials. However, there is limited real-world evidence regarding its effectiveness in clinical practice outside of the controlled research setting. METHODS: Patients hospitalized due to symptomatic HF between January 1 and December 30, 2023, were consecutively enrolled and divided into the vericiguat group and the control group. A total of 207 patients with left ventricular ejection fraction <45% were enrolled. RESULTS: Patients in the control group had a higher incidence of clinical endpoints than the vericiguat group: cardiac mortality and hospitalization for symptomatic HF during the median follow-up duration of 11.25 months. Patients in the vericiguat group demonstrated a higher event-free survival rate for both cardiac mortality and hospitalization for HF. In the univariable Cox regression analysis, vericiguat was found to be associated with a reduced risk of cardiac mortality (hazard ratio HR: 0.299, 95% confidence interval CI: 0.104-0.863, p = 0.026) and hospitalization for HF (HR: 0.586, 95% CI: 0.348-0.988, p = 0.045). After propensity score matching for age and sex, we observed that vericiguat's benefit on cardiac mortality was maintained. CONCLUSION: This prospective study is the first to report, using real-world data from a Chinese population with ventricular ejection fraction <45%, that vericiguat is associated with a lower incidence of clinical endpoints, including cardiac mortality and hospitalization for HF. These findings align with the results of previous clinical trials.