Vericiguat in Chinese patients with heart failure and reduced ejection fraction: a real-world prospective study

Background Vericiguat has been shown to improve clinical outcomes in patients with heart failure with reduced ejection fraction (HFrEF) in several randomized controlled trials. However, there is limited real-world evidence regarding its effectiveness in clinical practice outside of the controlled research setting. Methods and Results Patients hospitalized due to symptomatic heart failure (HF) between January 1st and December 30th, 2023, were consecutively enrolled and divided into a vericiguat group and a control group. A total of 207 patients were enrolled in the study. Patients in the control group had a higher incidence of clinical endpoints than the vericiguat group: cardiac death and hospitalization for symptomatic HF during the median follow-up duration of 11.25 months. Patients in the vericiguat group demonstrated a higher event-free survival rate for both cardiac death and hospitalization for HF. In the univariate Cox regression analysis, vericiguat was found to be negatively associated with cardiac death [hazard ratio (HR): 0.303, 95% confidence interval (CI): 0.100-0.860, p=0.026] and hospitalization for HF (HR: 0.590, 95% CI: 0.350-0.990, p=0.045). Subgroup analysis revealed that vericiguat was negatively related to cardiac death and hospitalization for HF in patients with lower ventricular ejection fraction or those taking angiotensin receptor-neprilysin inhibitors. Conclusion This prospective study is the first to report, using real-world data from a Chinese population with left ventricular ejection fraction (LVEF) <45%, that vericiguat is associated with a lower incidence of clinical endpoints, including cardiac death and hospitalization for HF. These findings align with the results of previous clinical trials.