Vericiguat in Patients with Heart Failure and Reduced Ejection Fraction
Vericiguat is an oral soluble guanylate cyclase stimulator. Its effect in patients with heart failure and reduced ejection fraction who had recently been hospitalized or had obtained intravenous diuretic therapy is unknown. The author Armstrong and colleagues (March 2020) have conducted a study titled “Vericiguat in Patients with Heart Failure and Reduced Ejection Fraction” published in “The New England Journal of Medicine”. The summary of the findings is below:
Objectives:
To investigate the effect of Vericiguat in patients of heart failure with reduced ejection fraction.
Method:
In the study, 5050 patients of chronic heart failure with an ejection fraction of less than 45% have participated. They were assigned to receive Vericiguat (target dose, 10 mg once daily) or placebo. Additionally, guideline-based medical therapy was provided. The primary outcome included a composite of death from cardiovascular causes or first hospitalization due to heart failure.
Findings:
As compared to the placebo group, there was a lower incidence of the all-death from cardiovascular causes or hospitalization for heart failure in Vericiguat group. This finding was observed after approximately three months of treatment with Vericiguat and persisted throughout the trial. As compared to placebo receiving patients, Vericiguat group experienced an incidence of symptomatic hypotension and syncope more commonly. On the other hand, the overall frequency of adverse events was similar in both groups.
As heart failure is becoming a burden globally, it is essential to note that this trial has shown greater than 89% adherence to Vericiguat (target 10-mg dose) after 12 months.
Limitations:
The authors acknowledge that the study failed to address the potential incremental role of Vericiguat due to the small number of patients who were already receiving inhibitors of sodium-glucose cotransporter 2.
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