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

Abstract

AimsThe 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).MethodsThis 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 ≥6 months' follow‐up was performed separately.ResultsOut of 103 patients initially included, 52 had a follow‐up of at least 6 months (median follow‐up of 303 days). At baseline, the mean age was 71.3 ± 9.4 years, 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 10 mg. The number of HF‐related hospitalizations/decompensations within the previous 12 months 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).ConclusionsIn 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.