Efficacy and Safety of Vericiguat in a Real-life Population with Heart Failure after 1 Year of Treatment: The VERITA Study.

AIM: To determine the efficacy and safety of vericiguat in a real-world cohort of patients with heart failure (HF) with reduced ejection fraction in Spain.

METHODS

A prospective observational study of HF with reduced ejection fraction patients with a recent episode of worsening HF, requiring IV therapy, and who initiated vericiguat in a HF outpatient clinic was carried out. Of the 103 patients included, 28 (27.2%) were women.

RESULTS

At baseline, the mean age was 71.3 ± 9.4 years, the median ejection fraction was 34% (interquartile range; IQR 28-39%) and N-terminal pro-B-type natriuretic peptide was 2,034 pg/ml (IQR 910-3,372 pg/ml). Regarding HF treatments, 99% of patients were taking β-blockers, 97.1% sodium-glucose cotransporter 2 inhibitors, 96.1% sacubitril-valsartan, 91.2% mineralocorticoid receptor antagonists and 93.2% loop diuretics. After 1 year of treatment with vericiguat, New York Heart Association functional class improved from 36.9 and 63.1% in classes II and III to 72.1 and 16.3%, respectively, as did the visual analogue scale score, from 60 (50-75) to 70 (50-85; both p<0.001). N-terminal pro-B-type natriuretic peptide levels decreased from 2,034 pg/ml (IQR 910-3,372 pg/ml) to 1,282 pg/ml (IQR 562-3,303 pg/ml; p=0.034). The dosage of angiotensin receptor-neprilysin inhibitors increased significantly (p<0.001), and the dose of furosemide was reduced (p=0.032). The number of HF-related hospitalisations/emergency department visits within the previous year was 1.9 ± 1.3, decreasing to 0.55 ± 0.98 (p<0.001). At study end, 7.8% of patients had died (one-quarter of HF). Only 11.7% of patients discontinued vericiguat (6.8% owing to hypotension), and 77.7% achieved the target dose of 10 mg.

CONCLUSION

In clinical practice, treatment with vericiguat is associated with substantial improvements in functional class and quality of life, reductions in natriuretic peptide levels and clinical events, and a good safety profile.