Heart failure & cardiomyopathiesSecondary analysis
Blood Pressure, Safety and Clinical Efficacy of Vericiguat in Chronic Heart Failure with Reduced Ejection Fraction: Insights from the VICTOR Trial
- Secondary analysis of the VICTOR randomised trial
- placebo-controlled
Authors' conclusion
Vericiguat showed a slight adjusted decrease in SBP and resulted in more symptomatic hypotension compared with placebo but was overall well-tolerated in a broad population with HFrEF on contemporary therapy even among those predisposed to hypotension. Treatment effects on efficacy outcomes were consistent regardless of baseline SBP.
Study context
- Population
- Chronic heart failure with reduced ejection fraction (HFrEF) on contemporary heart failure (HF) therapies without recent worsening, receiving ≥1 dose of study drug or placebo
- Comparison
- Vericiguat vs placebo
- Primary endpoint
- SBP trajectories over time (mean change from baseline), symptomatic hypotension and efficacy in vulnerable subgroups (SBP ≤110 mmHg, >75 years, ARNI or SGLT2i at baseline)
Primary result
SBP change from baseline
Placebo-corrected difference
−1.17
CI −1.84 to −0.50
P = 0.0007
Vericiguat vs Placebo
placebo-corrected difference −1.17 (CI −1.84 to −0.50); P = 0.0007
As reported in the abstract
Further findings
CV death and HF hospitalization; CV death, across baseline systolic blood pressure (SBP)
- Treatment effect of vericiguat vs placebo similar across baseline SBP
- both interaction p >0.15
Safety
| Outcome | Vericiguat | Placebo | adjusted HR (95% CI) | |
|---|---|---|---|---|
| Symptomatic hypotension | 11.3% | 9.2% | 1.24 (1.06–1.46) | |
| 0.512Adjusted hazard ratio (log scale) |
- Symptomatic hypotension — Similar across age, SBP, SGLT2i and angiotensin receptor-neprilysin inhibitors (ARNI) subgroups
- all interaction p >0.05
- Symptomatic hypotension: all interaction p >0.05
Original publication
Blood Pressure, Safety and Clinical Efficacy of Vericiguat in Chronic Heart Failure with Reduced Ejection Fraction: Insights from the VICTOR Trial. Eur J Heart Fail. Published 29 September 2025. doi:10.1002/ejhf.70033
Summarised from the published abstract; every number is checked against it