Clinical profile, associated events and safety of vericiguat in a real-world cohort: The VERITA study.

Abstract

The aim of this study was to determine the clinical profile, associated events and safety of vericiguat in a real-world cohort of patients with heart failure with reduced ejection fraction (HFrEF). This study is a prospective and observational cohort study of patients with HFrEF and recent HF worsening episodes requiring intravenous therapy who initiated vericiguat in an HF outpatient clinic. A subanalysis of patients with ≥6months' follow-up was performed separately. Out of 103 patients initially included, 52 had a follow-up of at least 6months (median follow-up of 303days). At baseline, the mean age was 71.3±9.4years, 27.2% were women, the median left ventricular ejection fraction was 34% (28%-39%) and 99% were taking beta-blockers, 96.1% sodium-glucose cotransporter-2 (SGLT2) inhibitors, 95.1% sacubitril-valsartan, 90.3% aldosterone antagonists and 93.2% loop diuretics. During follow-up, New York Heart Association (NYHA) functional class improved (from 67.3% and 32.7% in classes III and II, respectively, to 22.4% and 75.5% at study end; P<0.001), as did the EuroQol-5D (EQ-5D) and visual analogue scale (VAS) scores (from 0.83±0.13 to 0.87±0.12, P=0.032, and from 60 to 79, P=0.005, respectively). Vericiguat was well tolerated (13.5% had symptomatic hypotension, and 11.5% had discontinued treatment), and 78.8% of patients achieved the target dose of 10mg. The number of HF-related hospitalizations/decompensations within the previous 12months was 2.3±1.4 and decreased with vericiguat to 0.79±1.14 (P<0.001). At study end, 7.7% died (50% for HF). In clinical practice, treatment with vericiguat is associated with substantial improvements in functional class and quality of life and a reduction in hospitalizations for HF, with a low risk of adverse effects.