Vericiguat for patients with heart failure and reduced ejection fraction across the risk spectrum: an individual participant data analysis of the VICTORIA and VICTOR trials

作者：Faı̈ez Zannad, Christopher M. O’Connor, Javed Butler, Ciaran J. McMullan, Kevin J. Anstrom, Irina Barash, Marc P. Bonaca, Maria Borentain, Stefano Corda, Davis Gates, Justin A. Ezekowitz, Adrian F. Hernandez, Carolyn S P Lam, Eldrin F. Lewis, JoAnn Lindenfeld, Robert J. Mentz, Piotr Ponikowski, Yogesh N.V. Reddy, Giuseppe Rosano, Clara Saldarriaga, Michele Senni, P. Pinto Teixeira, James E. Udelson, Alessia Urbinati, Vanja Vlajnic, Adriaan A. Voors, Aiwen Xing, Mahesh J. Patel, Paul W. Armstrong, Paul W. Armstrong, Christopher M. O'Connor, Burkert Pieske, Kevin J. Anstrom, Javed Butler, Justin A. Ezekowitz, Adrian F. Hernandez, Carolyn S.P. Lam, Joerg Koglin, Piotr Ponikowski, Lothar Roessig, Adriaan A. Voors, Kris Reay, Lisa Soulard, Tracy Temple, Cynthia M. Westerhout, Robert J. Mentz, Mahesh J. Patel, Constance Hamlin, Rhonda Lovett, Nicholas Ryan, Robert O. Blaustein, Gregory T. Golm, Gang Jia, C.Harry Kent, Jaco De Klerk, Christina M. Salerno, Sabine Broeker-Zweering, Richard Nkulikiyinka, Elaine Wu, Katharina Mueller, Elisabeth Pieske‐Kraigher, Martin Kropf, Raymond J. Kim, Michele Parker, Sebastian Kelle, Jeanette Schulz‐Menger, Christopher R. deFilippi, Rachel Bell, Palak Shah, P.W. Shaw, Michael E. Lassman, Frank Kramer, Robert H. Christenson, Daniel B. Mark, Linda Davidson‐Ray, Maria Cecilia Bahit, David M. Kaye, Diana Bonderman, Anne–Catherine Pouleur, Edimar Alcides Bocchi, Fernando Laņas, Jian Zhang, Clara Saldarriaga, Vojtěch Melenovský, Jens Refsgaard, Johan Lassus, Alain Cohen‐Solal, Frank Edelmann, Dimitrios Tziakas, Juan L Arango Benecke, D. Siu, Ebrahim Noori, Kenneth McDonald, Basil S. Lewis, Michele Emdin, Michele Senni, Hiroyuki Tsutsui, Imran Zainal Abidin, Jorge Escobedo, Arend Mosterd, Richard W. Troughton, Dan Atar, Armando Lionel Godoy Palomino, Eugenio B Reyes, Jose Vazquez-Tanus, Myeong‐Chan Cho, Yury Lopatin, David Sim, Karen Sliwa‐Hahnle, José López-Sendón, Lars H. Lund, Chern‐En Chiang, Mehmet Ali Oto, Martín Cowie, Michael M. Givertz, Ileana L. Piña, Nancy K. Sweitzer, John J.V. McMurray, Christopher B. Granger, Thomas D. Cook, Gary S. Francis, Karl Swedberg, Haley Hedlin, G. Michael Felker, W Schuyler Jones, Karen P. Alexander, Sana M. Al‐Khatib, Keith Dombrowski, Robert W. Harrison, Renato D. Lopes, Robin Mathews, Thomas J. Povsic, Matthew T. Roe, Sreekanth Vemulapalli, Eduardo Perna, Maria Galarza Salazan, Ignacio MacKinnon, Florencia Eden, Luis R Cartasegna, V Novas, Hugo A Luquez, Ana Cenci, Miguel Hominal, Maria Veronica Bianchini, Rodolfo Andrés Ahuad Guerrero, A Amelio, Carlos Poy, María Laura Poy, Claudio Majul, Cecilia Currao, Ezequiel Hector Vottero, Mariana Perrin, Cesar Javier Zaidman, Marisa González Montero de Espinosa, Gerardo Zapata, Luciana Arias, Sonia A Sassone, Lucas Tonelli, Daniel Agustín Chirino Navarta, Maria Mangini, Jesus Cuadrado, Paula Bordoni, David Kaye, Kaye Carter, John Amerena, Toni Shanahan, Scott McKenzie, Kathryn Stibijl, Carmine G. De Pasquale, Fiona Wollaston, David Colquhoun, A. Ferreira-Jardim, Alicia Chan, Greer Dymmott, B. McQuillan, Katayun Mohammadi, D. Cross, Judy Jeffrey, Andrew Sindone, Magdalena Gebran, Amit Shah, Gill Tulloch, Maged William, Bets Conway, James Wong, Donna North, Dirk von Lewinski, Karin Brandner, Uta Hoppe, Kristen Kopp, Regina Mascherbauer, Claudia Steinkellner, Christina Binder, Christopher Adlbrecht, Maria Leitgeb, F Sinnaeve, Matthias Dupont, Carola Claes, Michel De Ceuninck, Els Vancayseele, Philippe Timmermans, G. Van Genechten, Pierre Troisfontaines, M Massoz, Thao Huynh, C. Boudreault, Eric Sabbah, Isabelle Chausse, Ronald Bourgeois, Karen Boyd, Michael Heffernan, Marie Birch, Marie-Claude Parent, Helene G. Brown, A. Shekhar Pandey, Tatiana Ballivian, Nadia Giannetti, Reza Sahebjamei, Saul Vizel, Beverley Fox, Dennis Rupka, Sandi Thiessen, Christian Constance, Marie‐France Gauthier, Quentin Kushnerik, Allan Schaffer, Wendy Janz, Michael Chan, Jennifer Knight, Serge Lepage, Daniel Soucy, John D. Parker, Elaine Hsu, Lisa Mielniczuk, Ermina Moga, Benoit Coutu, Julie Fleury, Paul C. MacDonald, Kathleen Hines, Diego Delgado, Natalia Nugaeva, Ying Sia, Isabelle Roy, David Laflamme, Christel Simard, Gilbert Gosselin, Katia Drouin, Brian Clarke, Kimberley Ronak, Denis Saulnier, Melissa D. Côté, Bruce Sussex, Bernadette Druken, Miroslaw Rajda, Jayne Falkenham, A. M. Mukherjee, Beverly Bozek, Gordon W. Moe, Carlos Fernando, Sébastien Bergeron, Hugo Tremblay, Marcelo C. Shibata, Bonnie L Woloschuk, Dante E. Manyari, Tracy Cleveland, Frank Nigro, Crystal Forsyth, Annie Roy, Helene Bolduc, Danielle Dion, Nancy E. Gilbert, James Y Cha, Judy Otis, Melinda Barabas, Marie-Josee Chartrand, Víctor Assef, Andrea Eikhof, Manuel Novajas Balboa, Carla Belen Aravena Vasquez, Juan Carlos Prieto Dominguez, Viviana Noriega, Patricio Yovaniniz, Marcela Grandon, Jessica Hidalgo, Yuhui Zhang, Jing Dong, Haiying Dai, Ying Xiao, Tingbo Jiang, Lin Shi, Jiyan Chen, Peiyu He, Daoquan Peng, Fangmei Qing, Biao Xu, Rui-Hong Wang, Xiang Gu, Min Wang, Zhuhua Yao, Ying Chen, Peizhi Miao, Zhenfei Chen, Hui Li, Dongyan Huang, Qin Yang, Xuefang Yu, Aidong Shen, Xin Zhang, Xiaohui Liu, Qiang Lv, Yugang Dong, Dan Liu, Jingfeng Wang, Huijun Ouyang, Chengchun Tang, Yong Chen, Hui Gong, Dandan Teng, Jing Yan, Linying Xu, Weihong Jiang, Xiaowei Zhou, Guosheng Fu, Ying Zheng, Shuyang Zhang, Lihong Xu, Zhenyu Yang, Chenying Wu, Xiumin Han, Yuxia Wang, Jing YU, Qiongying Wang, Lihong Wang, Lili Zheng, Wei Jin, Nan Zhang, Chuanhuan Zhang, Xiaojian Sun, Yali Yao, Peng Lei, Zhaofen Zheng, Junkui Wang, Fengling Ma, Mingzhi Long, Su-Lan Wang, Hong Zhang, Mingmei Guo, Manhua Chen, Yayun Wang, Zhanquan Li, Ruili Duan, Zuyi Yuan, Tiaotiao Li, Yibin Mei, Linyan Ye, Zhouqing Huang, Xingyuan Zhang, Wenling Liu, Lei Li, Ruiping Zhao, Jie Gong, Dongqing Zhang, Jiahui Zhu, Chengjian Yang, Chunxia Wang, Zheng Ji, Xinpei Gao, Mei Xia, Mingyun Liu, Paula Garcia Amaya, Wilder Castano Osorio, Maria Dussan, Franklin Roberto Quiroz Diaz, Yuleth Prada, Carlos Francisco Jaramillo Munoz, Ana Isabel Pérez Zapata, Mónica Jaramillo, Solmara Bello, Rodrigo Botero, Sandra Salazar, Monica Lopez Pareja, Claudia Mora, Nicolas Ignacio Jaramillo Gomez, Juan Camilo García, Fabián Llorens Torres, Miguel Moncada, Laura Velez Gil, Jaime Andres Torres, Yolanda Lievano, Vojtěch Melenovský, Miroslava Krausova, Jan Malík, Martin Hajšl, Kateřina Malá, Jan Vojáček, Jana Fridrichova, Filip Málek, D Ríhová, Vladimir Cech, Lenka Masarikova, Vilma Machova, Jindřich Špinar, Jan Machá, Libor Nechvátal, Kenneth Egstrup, Lene Moltrup, Benedikte Haastrup, Camilla Jespersen, Ole Nyvad, Lene Tanggaard, Lars Fog, Pauline Gøgsig Johansen, Henrik Wiggers, Kristine Serup-Hansen, Jens D Lomholdt, Kari Niemann, Olav Wendelboe Nielsen, Elisa Stokholm, Mustafa Taskiran, Lotte Ring Pedersen, Kai Nyman, Tiina Sankari, Heikki Ukkonen, Tuija Vasankari, Sari Karesvuori, Miguel Vazquez Ibarra, Karim Gallouj, Angelique Lombart, Thibaud Damy, Mounira Karhoubi, Michel Galinier, Nathalie Rosoli, Guillaume Taldir, Maelle Vomscheid, Jean-Michel Tartiere, Charline Genin, Muriel Salvat, Delphine Pollet, Bernard Citron, Ouarda Lamallem, Nicolas Girerd, Lydie Poinsignon, François Jourda, Emmanuelle Mougenot, Hatem Boughanmi, Hanane Fodil, Lionel Benhamou, Ghania Harzi, Stefan Störk, A Knoppe, Karl‐Friedrich Appel, Petra Becker, Johann Bauersachs, Manuela Geyer, Ekkehard Schmidt, Kristina Schmidt, Sophia Strempel, Daniel Beug, Michael Bruder, Michael Jeserich, Mariana Rupprecht, Hendrik Haake, Bianca Krug-Hoeren, Andreas Hagenow, Anja Kuntzsch, Mirjana Vojvodic-Mayer, Ronny Lux, Thomas Horacek, Manuela Pluemer-Schmidt, Markus Knapp, Edith Suepple-Poch, Veselin Mitrović, Annerose Peil, Stephan Rosenkranz, Susanne Roelle-Hoehne, Raffi Bekeredjian, Ina Probst, Izabela Tuleta, Marjo Lauterborn, Bernhard R. Winkelmann, Linda Tenbusch, Wolfgang Zeh, Sandra Eble, Mirjam Keßler, U. Dichristin, Lars S. Maier, Esther Kellner, Dimitrios Tziakas, Georgios Chalikias, Filippos Triposkiadis, Michalis Papamichalis, John Parissis, Vasiliki Bistola, Haralampos Karvounis, Georgios Giannakoulas, Dimitrios Tousoulis, Christina Chrysohoou, Katerina Κ. Naka, Anna Kotsia, Pablo Carlos Montenegro Valdovinos, Mayra Aguilar, Ronaldo A. Gonzalez Orellana, Ester Meléndez, Lissette Garcia de Krumbach, Edgar Rolando Rodríguez, Karla Barrera, Mynor Adolfo Aguilar Vásquez, Chung‐Wah Siu, Venus San Lui Ho, Pui-Wai Alex Lee, Xue Ting Wang, Katherine Fan, Eva Wai-Ying Tam, Gyongyver Ibolya Mihaly, Ákos Kalina, Anita Szabó, Sándor Kancz, Istvanne Hentzel, Ferenc Lakatos, Krisztina Tóth, Bela Merkely, Laura Dzsida, Attila Pálinkás, Szilvia Rostasne Toth, Marianna Svab, B Bugarin-Horvath, Robert J. Kirschner, Rozsa Toth Karolyne, Joanne Maher, Ross Murphy, Mary Hall, Niall Mahon, Elaine Gilroy, Brendan McAdam, David Farrell, James O ́Neill, Ciara Blaine, Shaul Atar, Rita Nadaf, Tony Hayek, Mira Hassan, Lena Zarachovsky, Michael Shochat, Ilana Aloni, Abid Assali, Elena Tsirulnikov, Wadi Kinany, Janna Etkin, Tuvia Ben Gal, Hadas Even Nir, Yaron Arbel, Adi Katalan Shani, Elias Mazen, Gilat Ron Avraham, Sorel Goland, Anastasia Suzdalnizki, Majdi Halabi, Ilana Portnov, Tal Hasin, Astrid Rojansky, Rafat Jabara, Galina Levin, Amos Katz, Orna Tubul, Gil Moravsky, İra M. Lapıdus, Marilisa Ambrosio, Claudio Passino, Alessandra Gabutti, Laura Scelsi, Eleonora Lo Vullo, Paolo Midi, A. 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Nagashima, Taro Shibasaki, N. Takahashi, Harukazu Iseki, Kenichi Otsuki, Shunzo Matsuoka, Kentaro Motoda, Yoshiharu Higuchi, Hiromi Hayasaki, Mamoru Manita, Riyo Ito, Masahiro Suzuki, Kaori Fumikura, Hiroshi Iwata, Kaori Kinjo, Eiki Takimoto, Yuki Omori, Kazuhiko Yumoto, Jun Yoshizawa, Chisato Izumi, Kanae Hirase, Shinichi Higashiue, Ayaka Ishibaba, Yorihiko Higashino, Takuro Matsumura, Hiroshi Iida, Kaya Kowa, Tokushi Koga, Tomomi Hatakeda, Nobuhiko Atsuchi, Kana Migita, Yukihiko Momiyama, Yusuke Fukuda, Masataka Fukue, Kouji Uchida, Kozue Saito, Sakiko Iida, Seiji Fukamizu, Junko Harada, Yasuyoshi Takei, Saori Takano, Yoshiki Hata, Arisa Sato, Yumi Shimura, Shinko Hirata, Atsuo Namiki, N. Ishida, Ichiro Michishita, Tomomi Ishimoto, Kazuo Usuda, Akiko Oomura, Koichiro Kinugawa, Rumi Sasaki, Takao Matsubara, Hiromi Kidani, Yoshifumi Awaji, Yoko Kaneno, Kentaro Yamashita, Masami Suzuki, Hiroshi Fujita, Aya Mashida, Takahisa Yamada, Shintaro Hirai, Minoru Ichikawa, Takae Muromaki, Tomohito Ohtani, Sachiyo Yamaguchi, Yutaka Furukawa, Mika Takata, Masato Baden, Futoshi Kawasaki, Hideki Tashiro, Yuko Kita, Mizuri Taki, Kuniko Suzuki, Kenji Nakama, Chiaki Oota, Kiyoshi Hibi, Mizuho Shiono, Satoaki Matoba, Natsuki Kimura, Akihiko Takahashi, Megumi Fujino, Tomomi Ide, Chiharu Tanaka, Osamu Ueda, Rieko Shimojima, Takehiko Kuramochi, Michiko Ando, Haruhiko Onaka, Anri Maeda, Tetsuya Higami, Ikumi Nishibe, Mitsunori Abe, Megumi Matsugi, Junya Ako, Kimiko Yamamura, Tomoya Ueda, Yuki Itokazu, Kotaro Sumii, Kano Ichii, Masatoshi Shimizu, Megumi Irikura, Shigeo Shimizu, Misa Ayabe, Taku Matsubara, Satoko Kaneko, Tomomi Koizumi, Keiko Watanabe, Satoru Sakagami, Mariko Kumaki, Atsushi Suzuki, Tomoe Kawano, Yusuke Katayama, Hiroko Nakamura, Isao Taguchi, Yuko Araki, Nobuyoshi Higa, Yasuka Oshiro, Kumiko Yahikozawa, Shiori Anzai, Tatsuya Nunohiro, Daichi Nishi, Shuichi Osaki, Yoshiaki Tanaka, Masayuki Kaneko, Kimiko Noguchi, Noriaki Watanabe, Toru Oishi, Koichi Fuse, Yukari Baba, Gaeun Kim, Jin-Ok Jeong, Youngeun Choi, Hae‐Young Lee, Eunjin Hur, Seok‐Min Kang, WonMi Lee, Kye Hun Kim, Jiyeon Song, Byung‐Su Yoo, Seonmi Shin, Mi‐Seung Shin, Hei Won Oh, Eung Ju Kim, JinJu Park, Dong‐Ju Choi, Eun Ji Yoon, Dong Heon Yang, JiHyeong Choi, Jung-Hyun Choi, Hwa‐Young Jeong, Jin-Oh Choi, Seo Jin Hyun, Sang‐Ho Jo, Lee Sujin, Dong‐Kyu Jin, Jiwon Jeon, Joon‐Han Shin, Ji Sung Na, Dong-Soo Kim, Eunryul Oh, Tiong Kiam Ong, Juriah Sulehan, Hamat Hamdi Che Hassan, Zati Amni, Siti Khairani Zainal Abidin, Kanaga Lakshimi Ravinttiran, Manuel Odin de Los Rios Ibarra, Carlos R. 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Rymer, Cina Sasannejad · 发表于：The Lancet · 年份：2025 · DOI：10.1016/s0140-6736(25)01682-4 · 被引用次数：44 · 研究领域：Heart Failure Treatment and Management、Diabetes Treatment and Management、Cardiac pacing and defibrillation studies

BACKGROUND: Following completion of the VICTORIA trial, vericiguat was approved for the treatment of worsening heart failure with reduced ejection fraction (HFrEF) and received a class IIb recommendation in European and North American guidelines. The subsequent VICTOR trial evaluated the use of vericiguat in patients with HFrEF and no recent worsening. We aimed to assess the effect of vericiguat on clinical endpoints through pooled analyses of patient-level data from the VICTORIA and VICTOR trials. METHODS: This prespecified, pooled individual participant-level analysis was conducted on data from two trials: VICTORIA, which was active from Sept 25, 2016, to Sept 2, 2019 in 42 countries, and VICTOR, which was active from Nov 2, 2021, to Feb 5, 2025 in 36 countries. The VICTORIA trial enrolled adult (aged ≥18 years) participants with HFrEF with recent worsening (defined as either hospitalisation for heart failure within the previous 6 months or outpatient use of intravenous diuretics within the previous 3 months) and increased NT-proBNP concentrations; the VICTOR trial had similar eligibility criteria but participants had no recent worsening of heart failure. Participants in both trials received contemporary background guideline-directed heart failure therapy as appropriate. The primary endpoint was a composite endpoint of cardiovascular death or hospitalisation for heart failure (also assessed individually). This study is registered with PROSPERO, CRD420251065636. FINDINGS: Da...