Vericiguat for HFrEF

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Vericiguat for HFrEF

Vericiguat is a new medication for heart failure with reduced ejection fraction (HFrEF). It is an oral soluble guanylate cyclase stimulator. VICTORIA trial [1] evaluated the efficacy of the drug in a phase 3 double blind randomized placebo controlled trial. There were over five thousand patients with chronic heart failure with NYHA (New York Heart Association) functional class II, III or IV in this study. They had a left ventricular ejection fraction less than 45% and vericiguat with a target dose of 10 mg was evaluated in comparison with placebo. The medication was added over and above guideline based medical therapy.

Primary outcome assessed was the composite of death from cardiovascular causes and hospitalisation for heart failure. The median follow up was 10.8 months. Primary outcome occurred in 35.5% in vericiguat group and 38.5% in placebo group (P = 0.02). 27.4% in the vericiguat group and 29.6% in the placebo group were hospitalized with heart failure during the study period. Though a significant mortality benefit could not be demonstrated in the study period, this is a new addition to our therapeutic armamentarium for treatment of heart failure with reduced ejection fraction.


  1. Armstrong PW, Pieske B, Anstrom KJ, Ezekowitz J, Hernandez AF, Butler J, Lam CSP, Ponikowski P, Voors AA, Jia G, McNulty SE, Patel MJ, Roessig L, Koglin J, O’Connor CM; VICTORIA Study Group. Vericiguat in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2020 Mar 28. doi: 10.1056/NEJMoa1915928. [Epub ahead of print]