- Question
- To determine whether vericiguat, an oral soluble guanylate cyclase stimulator, reduces cardiovascular death or heart failure hospitalization in high-risk patients with heart failure with reduced ejection fraction (recent hospitalization or intravenous diuretic therapy).
- Design
- Phase 3, randomized, double-blind, placebo-controlled, event-driven multicenter trial enrolling 5050 patients, with a median follow-up of 10.8 months.
- Population
- Patients with chronic heart failure in NYHA class II, III, or IV and an ejection fraction below 45%, with a recent heart failure hospitalization or intravenous diuretic therapy, receiving guideline-based medical therapy.
- Intervention
- Oral vericiguat once daily, starting at 2.5 mg and uptitrated to a target dose of 10 mg, on top of standard therapy.
- Control
- Matching placebo with the same uptitration schedule, on top of standard heart failure therapy.
- Primary outcome
- Composite of death from cardiovascular causes or first hospitalization for heart failure.
- Results
- The primary outcome occurred in 897 of 2526 patients (35.5%) with vericiguat and 972 of 2524 (38.5%) with placebo (HR 0.90; 95% CI 0.82 to 0.98; P = 0.02). Cardiovascular death occurred in 16.4% with vericiguat and 17.5% with placebo (HR 0.93; 95% CI 0.81 to 1.06).
- Safety
- Symptomatic hypotension occurred in 9.1% with vericiguat and 7.9% with placebo (P = 0.12); syncope occurred in 4.0% and 3.5%, respectively (P = 0.30).
- Conclusion
- Among patients with high-risk heart failure, vericiguat lowered the incidence of cardiovascular death or heart failure hospitalization compared with placebo.
- Why it matters
- It provided an additional option for patients with heart failure with reduced ejection fraction who have recently experienced worsening disease, a population with high residual risk despite standard therapy.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026