Clinical profile of an unselected population with heart failure treated with vericiguat in real life: differences with the VICTORIA trial

IntroductionVericiguat, an oral stimulator of soluble guanylate cyclase, reduces cardiovascular mortality and hospitalisations in patients with heart failure (HF) and reduced ejection fraction, as demonstrated in the VICTORIA trial. This study assessed the real-world use of vericiguat.Material and m...

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Main Authors: Alberto Esteban-Fernández, Alejandro Recio-Mayoral, Raquel López-Vilella, Gregorio de Lara, Moisés Barrantes-Castillo, Inés Gómez-Otero, Julio Nuñez-Villota, Carolina Robles-Gamboa, José López-Aguilera, Ángel Iniesta-Manjavacas, Paula Fluviá, Francisco Pastor-Pérez, Laia Belarte-Tornero, Gonzalo Alonso-Salinas, Pablo Díez-Villanueva
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2024.1504427/full
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author Alberto Esteban-Fernández
Alberto Esteban-Fernández
Alejandro Recio-Mayoral
Raquel López-Vilella
Raquel López-Vilella
Gregorio de Lara
Moisés Barrantes-Castillo
Inés Gómez-Otero
Inés Gómez-Otero
Julio Nuñez-Villota
Julio Nuñez-Villota
Julio Nuñez-Villota
Julio Nuñez-Villota
Carolina Robles-Gamboa
José López-Aguilera
Ángel Iniesta-Manjavacas
Paula Fluviá
Francisco Pastor-Pérez
Laia Belarte-Tornero
Gonzalo Alonso-Salinas
Pablo Díez-Villanueva
author_facet Alberto Esteban-Fernández
Alberto Esteban-Fernández
Alejandro Recio-Mayoral
Raquel López-Vilella
Raquel López-Vilella
Gregorio de Lara
Moisés Barrantes-Castillo
Inés Gómez-Otero
Inés Gómez-Otero
Julio Nuñez-Villota
Julio Nuñez-Villota
Julio Nuñez-Villota
Julio Nuñez-Villota
Carolina Robles-Gamboa
José López-Aguilera
Ángel Iniesta-Manjavacas
Paula Fluviá
Francisco Pastor-Pérez
Laia Belarte-Tornero
Gonzalo Alonso-Salinas
Pablo Díez-Villanueva
author_sort Alberto Esteban-Fernández
collection DOAJ
description IntroductionVericiguat, an oral stimulator of soluble guanylate cyclase, reduces cardiovascular mortality and hospitalisations in patients with heart failure (HF) and reduced ejection fraction, as demonstrated in the VICTORIA trial. This study assessed the real-world use of vericiguat.Material and methodsThis cross-sectional, prospective and multicenter registry (VERISEC) included 776 patients from 43 centres in Spain between December 2022 and October 2023. Of these patients, 79.6% were male, with a mean age of 72.4 (SD:8.7) years. Patients in VERISEC were older and had more comorbidities (diabetes, advanced chronic kidney disease) compared to VICTORIA, with 20% having an estimated glomerular filtration rate below 30 ml/min. They also had higher natriuretic peptide levels [NT-proBNP: 3551 (IQR: 1,675.9, 7,054.0)] pg/ml. Most patients (79.8%) started vericiguat after HF decompensation within the previous three months, with high use of loop diuretics (with an average dose of 65 mg/day) and implanted devices (50%). Sixty percent of patients were on quadruple therapy, with a higher use of sodium-glucose co-transporter 2 inhibitors compared to the VICTORIA trial. Despite the more severe disease in the VERISEC cohort, the implementation of guideline-directed medical therapy was greater than in VICTORIA, although vericiguat was initiated at lower blood pressure levels.ConclusionsPatients in the VERISEC registry had more severe illness and higher comorbidities compared to those in the VICTORIA, despite receiving optimised treatments. Further research is needed to identify which patients may benefit the most from vericiguat treatment.
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spelling doaj-art-bae083b39bcc4e5595c0362e97e3619b2025-01-09T14:21:00ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011110.3389/fcvm.2024.15044271504427Clinical profile of an unselected population with heart failure treated with vericiguat in real life: differences with the VICTORIA trialAlberto Esteban-Fernández0Alberto Esteban-Fernández1Alejandro Recio-Mayoral2Raquel López-Vilella3Raquel López-Vilella4Gregorio de Lara5Moisés Barrantes-Castillo6Inés Gómez-Otero7Inés Gómez-Otero8Julio Nuñez-Villota9Julio Nuñez-Villota10Julio Nuñez-Villota11Julio Nuñez-Villota12Carolina Robles-Gamboa13José López-Aguilera14Ángel Iniesta-Manjavacas15Paula Fluviá16Francisco Pastor-Pérez17Laia Belarte-Tornero18Gonzalo Alonso-Salinas19Pablo Díez-Villanueva20Cardiology Service, Hospital Universitario Severo Ochoa, Madrid, SpainFaculty of Health Sciences, Alfonso X El Sabio University, Madrid, SpainCardiology Service, Hospital Universitario Virgen Macarena, Sevilla, SpainCardiology Service, Hospital Universitari I Politécnic La Fe, Valencia, SpainCentro de Investigación Biomedica en Red Cardiovascular (CIBERCV), Madrid, SpainCardiology Service, Hospital Universitario de Torrevieja, Alicante, SpainCardiology Service, Hospital de Palamós, Gerona, SpainCentro de Investigación Biomedica en Red Cardiovascular (CIBERCV), Madrid, SpainCardiology Service, Hospital Clínico Universitario de Santiago de Compostela, La Coruña, SpainCentro de Investigación Biomedica en Red Cardiovascular (CIBERCV), Madrid, SpainCardiology Service, Hospital Clínico Universitario de Valencia, Valencia, Spain0Insitute of Health Research-INCLIVA, Valencia, Spain1Universidad de Valencia, Valencia, Spain2Cardiology Service, Hospital Universitario de Toledo, Toledo, Spain3Cardiology Service, Hospital Universitario Reina Sofía, Córdoba, Spain4Cardiology Service, Hospital Universitario LaPaz, Madrid, Spain5Cardiology Service, Hospital Universitario Dr. Trueta, Gerona, Spain6Cardiology Service, Hospital Clínico Universitario Virgen de la Arixaca, Murcia, Spain7Cardiology Service, Hospital del Mar, Barcelona, Spain8Cardiology Service, Hospital Universitario de Navarra, Pamplona, Spain9Cardiology Service, Hospital Universitario de La Princesa, Madrid, SpainIntroductionVericiguat, an oral stimulator of soluble guanylate cyclase, reduces cardiovascular mortality and hospitalisations in patients with heart failure (HF) and reduced ejection fraction, as demonstrated in the VICTORIA trial. This study assessed the real-world use of vericiguat.Material and methodsThis cross-sectional, prospective and multicenter registry (VERISEC) included 776 patients from 43 centres in Spain between December 2022 and October 2023. Of these patients, 79.6% were male, with a mean age of 72.4 (SD:8.7) years. Patients in VERISEC were older and had more comorbidities (diabetes, advanced chronic kidney disease) compared to VICTORIA, with 20% having an estimated glomerular filtration rate below 30 ml/min. They also had higher natriuretic peptide levels [NT-proBNP: 3551 (IQR: 1,675.9, 7,054.0)] pg/ml. Most patients (79.8%) started vericiguat after HF decompensation within the previous three months, with high use of loop diuretics (with an average dose of 65 mg/day) and implanted devices (50%). Sixty percent of patients were on quadruple therapy, with a higher use of sodium-glucose co-transporter 2 inhibitors compared to the VICTORIA trial. Despite the more severe disease in the VERISEC cohort, the implementation of guideline-directed medical therapy was greater than in VICTORIA, although vericiguat was initiated at lower blood pressure levels.ConclusionsPatients in the VERISEC registry had more severe illness and higher comorbidities compared to those in the VICTORIA, despite receiving optimised treatments. Further research is needed to identify which patients may benefit the most from vericiguat treatment.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1504427/fullvericiguatworsening heart failureguideline-directed medical therapyVERISEC registryheart failure reduced ejection fraction
spellingShingle Alberto Esteban-Fernández
Alberto Esteban-Fernández
Alejandro Recio-Mayoral
Raquel López-Vilella
Raquel López-Vilella
Gregorio de Lara
Moisés Barrantes-Castillo
Inés Gómez-Otero
Inés Gómez-Otero
Julio Nuñez-Villota
Julio Nuñez-Villota
Julio Nuñez-Villota
Julio Nuñez-Villota
Carolina Robles-Gamboa
José López-Aguilera
Ángel Iniesta-Manjavacas
Paula Fluviá
Francisco Pastor-Pérez
Laia Belarte-Tornero
Gonzalo Alonso-Salinas
Pablo Díez-Villanueva
Clinical profile of an unselected population with heart failure treated with vericiguat in real life: differences with the VICTORIA trial
Frontiers in Cardiovascular Medicine
vericiguat
worsening heart failure
guideline-directed medical therapy
VERISEC registry
heart failure reduced ejection fraction
title Clinical profile of an unselected population with heart failure treated with vericiguat in real life: differences with the VICTORIA trial
title_full Clinical profile of an unselected population with heart failure treated with vericiguat in real life: differences with the VICTORIA trial
title_fullStr Clinical profile of an unselected population with heart failure treated with vericiguat in real life: differences with the VICTORIA trial
title_full_unstemmed Clinical profile of an unselected population with heart failure treated with vericiguat in real life: differences with the VICTORIA trial
title_short Clinical profile of an unselected population with heart failure treated with vericiguat in real life: differences with the VICTORIA trial
title_sort clinical profile of an unselected population with heart failure treated with vericiguat in real life differences with the victoria trial
topic vericiguat
worsening heart failure
guideline-directed medical therapy
VERISEC registry
heart failure reduced ejection fraction
url https://www.frontiersin.org/articles/10.3389/fcvm.2024.1504427/full
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