Vericiguat in Patients with Heart Failure and Reduced Ejection Fraction

This phase 3, randomized, double-blind, placebo-controlled trial (VICTORIA) evaluated the efficacy and safety of vericiguat, an oral soluble guanylate cyclase stimulator, in 5,050 patients with chronic heart failure (NYHA class II–IV) and reduced ejection fraction (<45%) who had recently been hospitalized or received IV diuretics. Patients were assigned to vericiguat (10 mg daily) or placebo alongside guideline-based therapy. Over a median of 10.8 months, the primary outcome death from cardiovascular causes or first hospitalization for heart failure occurred in 35.5% of the vericiguat group versus 38.5% in the placebo group (HR 0.90; 95% CI, 0.82–0.98; P=0.02). Vericiguat reduced total heart failure hospitalizations and had a modest but statistically significant benefit, especially in patients at high risk. Side effects included slightly more symptomatic hypotension and anemia, but overall safety was comparable to placebo.

This phase 3, randomized, double-blind, placebo-controlled trial (VICTORIA) evaluated the efficacy and safety of vericiguat, an oral soluble guanylate cyclase stimulator, in 5,050 patients with chronic heart failure (NYHA class II–IV) and reduced ejection fraction (<45%) who had recently been hospitalized or received IV diuretics. Patients were assigned to vericiguat (10 mg daily) or placebo alongside guideline-based therapy. Over a median of 10.8 months, the primary outcome death from cardiovascular causes or first hospitalization for heart failure occurred in 35.5% of the vericiguat group versus 38.5% in the placebo group (HR 0.90; 95% CI, 0.82–0.98; P=0.02). Vericiguat reduced total heart failure hospitalizations and had a modest but statistically significant benefit, especially in patients at high risk. Side effects included slightly more symptomatic hypotension and anemia, but overall safety was comparable to placebo.