Effect of Vericiguat on Total Heart Failure Events in Compensated Outpatients With HFrEF

作者：Faiez M. Zannad, Yogesh N.V. Reddy, Irina Barash, Kevin Joseph Anstrom, Marc P. Bonaca, Maria Borentain, Stefano Corda, Pedro Teixeira, Justin Adrian Ezekowitz, Davis F. Gates, Carolyn S.P. Lam, Eldrin Foster Lewis, JoAnn Lindenfeld, Ciaran J. McMullan, Robert John Mentz, Christopher M. O’Connor, Piotr Ponikowski, Giuseppe M.C. Rosano, Clara Saldarriaga, Michele Senni, James E. Udelson, Alessia Urbinati, Vanja Vlajnic, Adriaan A. Voors, Aiwen Xing, Mahesh J. Patel, Javed Butler · 发表于：Journal of the American College of Cardiology · 年份：2025 · DOI：10.1016/j.jacc.2025.08.051 · 被引用次数：20 · 研究领域：Heart Failure Treatment and Management、Cardiovascular Function and Risk Factors、Diabetes Treatment and Management

BACKGROUND: In the VICTOR (Vericiguat Global Study in Participants With Chronic Heart Failure) trial, in a contemporary ambulatory cohort with heart failure and reduced ejection fraction (HFrEF) and no recent hospitalization, the primary outcome of hospitalization for heart failure (HHF) and cardiovascular death was not statistically significantly reduced with vericiguat. Vericiguat reduced risk of mortality but not HHF. In this ambulatory compensated cohort, time to first HHF may underestimate the overall worsening HF burden by failing to consider the high proportion of outpatient worsening HF events. OBJECTIVES: This study aimed to determine the effect of vericiguat on the overall risk of worsening HF by incorporating the entire patient experience of worsening outpatient and inpatient HF episodes. METHODS: VICTOR was a phase 3, double-blind, placebo-controlled trial testing the effect of vericiguat in ambulatory patients with HFrEF who had not experienced recent worsening (defined as HHF admission within 6 months or outpatient intravenous diuretic use within 3 months) and were on a background of high use of contemporary guideline therapy. The primary endpoint was a composite of cardiovascular death or HHF. The current analysis provides detailed effects of vericiguat on overall worsening HF in both the inpatient and outpatient settings, including urgent care visits for intravenous diuretics or outpatient oral diuretic initiation or intensification. RESULTS: A total of 6,105 ...