Heart failure & cardiomyopathiesSecondary analysis
Diuretic Use and Outcomes in Patients with Heart Failure with Reduced Ejection Fraction: Insights from the VICTORIA Trial
- Secondary analysis of the VICTORIA randomised trial
Authors' conclusion
Loop diuretic TDD at randomization was independently associated with worse outcomes in this high-risk population. The efficacy of vericiguat was consistent across the range of diuretic doses.
Study context
- Population
- Patients with HFrEF enrolled after a worsening HF event98% of the trial
- Participants
- 4,974 patients
- Comparison
- Vericiguat vs placebo, by loop diuretic total daily dose (TDD) at randomisation
- No loop diureticn = 540
- 1-39 mgn = 647
- 40 mgn = 1,633
- 41-80 mgn = 1,185
- >80 mgn = 969
- Primary endpoint
- Primary composite outcome of:
- Cardiovascular death (CVD)/heart failure hospitalization (HFH) and its components
- By TDD loop diuretic
Primary result
As reported in the abstract
CV death/HF hospitalisation by TDD
No significant interaction between TDD and efficacy of vericiguat vs placebo for any outcome
all pinteraction > 0.5
Further findings
| Outcome | Vericiguat | Placebo |
|---|---|---|
| Post-randomisation diuretic dose changes (per 100 person-years) | ||
| Up-titration | 19.6 | 20.2 |
| Down-titration | 16.8 | 18.1 |
| Stopping diuretics | 22.9 | 24.2 |
Post-randomisation diuretic dose changes (per 100 person-years)
- Similar rates with vericiguat and placebo
Original publication
Diuretic Use and Outcomes in Patients with Heart Failure with Reduced Ejection Fraction: Insights from the VICTORIA Trial. Eur J Heart Fail. Published 7 March 2024. doi:10.1002/ejhf.3179
Summarised from the published abstract; every number is checked against it