Heart failure & cardiomyopathies
Effect of Vericiguat on Total Heart Failure Events in Compensated Outpatients With Heart Failure and Reduced Ejection Fraction (HFrEF): Insights From VICTOR
Primary result · Overall worsening HFResult — go to the resultHazard ratio 0.90 95% CI 0.81–1.00Authors' conclusion
In compensated patients with HFrEF on contemporary guideline therapy, worsening HF in outpatients was more common than HHF and was associated with higher risk of mortality. Exploratory analyses suggested a potential reduction in overall worsening HF events when both inpatient and outpatient settings were considered.
Study context
- Population
- Ambulatory patients with HFrEF without recent worsening (no hospitalization for heart failure (HHF) admission within 6 months or outpatient IV diuretic within 3 months), on high use of contemporary guideline therapy
- Participants
- 6,105 patients
- Comparison
- Vericiguat vs placebo
- Primary endpoint
- Composite of:
- CV death
- HHF (the VICTOR trial's primary endpoint)
Methodological detailsphase 3, double-blind, placebo-controlled, exploratory analysis
- Phase 3
- Double-blind
- Placebo-controlled
- Exploratory analysis
Primary result
Overall worsening HF
Hazard ratio
0.90
95% CI 0.81–1.00
P = 0.047
Events by treatment group
Vericiguat vs Placebo
HR 0.90 (95% CI 0.81–1.00); P = 0.047
As reported in the abstract
Further findings
| Outcome | Vericiguat | Placebo | Estimate | P value | |
|---|---|---|---|---|---|
| All-cause death or overall worsening HF | 30.0% | 32.9% | HR 0.90 (95% CI 0.82–0.98) | P = 0.016 | |
| Mortality after outpatient oral diuretic initiation or intensification · association with increased mortality | RR 1.69 (95% CI 1.47–1.94) | P < 0.001 | |||
| 0.512Ratio (log scale) |
Type of first worsening HF event
- Outpatient worsening HF
- n = 851, 59.3%
- HHF
- n = 507, 35.4%
- Urgent HF visits
- n = 76, 5.3%
Original publication
Effect of Vericiguat on Total Heart Failure Events in Compensated Outpatients With HFrEF: Insights From VICTOR. J Am Coll Cardiol. Published 27 August 2025. doi:10.
Summarised from the published abstract; every number is checked against it