Why the study?
Does vericiguat reduce heart failure hospitalization or cardiovascular death in HFrEF patients compared to placebo, and does background sacubitril/valsartan use affect this?
Does vericiguat reduce heart failure hospitalization or cardiovascular death in HFrEF patients compared to placebo, and does background sacubitril/valsartan use affect this?
Answers are grounded in this paper and cite their sources.
This editorial emphasizes that while vericiguat provides a modest benefit in HFrEF regardless of background sacubitril/valsartan, the low baseline use of sacubitril/valsartan highlights ongoing clinical inertia in heart failure management.
The understanding of the efficacy and safety of combinations of pharmacological therapies has become ever more important as the number of drugs available to treat heart failure has increased.Beyond these general considerations, there may also be particular combinations of treatments where there is a more specific question.One example is the addition of vericiguat to background treatment with sacubitril/valsartan.Both stimulation of soluble guanylyl cyclase (sGC) by vericiguat and inhibition of neprilysin (which breaks down natriuretic and other vasoactive peptides) by sacubitril increase the intracellular second messenger cyclic guanosine monophosphate (cGMP). 1 Among other downstream effects, cGMP causes vasodilatation by inducing smooth muscle
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Butt et al. (2022) conducted an editorial in Heart failure with reduced ejection fraction (n=5,040). Vericiguat vs. Placebo was evaluated on Time-to-first heart failure hospitalization or death from cardiovascular causes (HR 0.90, 95% CI 0.82, 0.98).
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