Vericiguat — Another Victory for Targeting Cyclic GMP in Heart Failure

Pivotal advances in basic scientific investigation have led to innovative drugs that have reduced the burden of cardiovascular disease in humans. There is no better example than the Nobel Prize–winning work of Furchgott, Ignarro, and Murad, who discovered that nitric oxide is an endothelial relaxing factor that mediates its favorable cardiovascular actions with the effector molecule 3′,5′-cyclic guanosine monophosphate (GMP).1 Subsequent studies established that the key target of nitric oxide is activation of soluble guanylyl (sometimes called “guanylate”) cyclase, which generates cyclic GMP. Indeed, cyclic GMP has emerged as a key intracellular second messenger that mediates protective cardiovascular, renal, neurohormonal, . . .