Heart failure & cardiomyopathiesSecondary analysis
Effect of Vericiguat on Total Heart Failure Events in Compensated Outpatients With Heart Failure and Reduced Ejection Fraction (HFrEF)
- Secondary analysis of the VICTOR randomised trial
- phase 3
- double-blind
- placebo-controlled
- exploratory analysis
Authors' 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)
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. J Am Coll Cardiol. Published 27 August 2025. doi:10.1016/j.jacc.2025.08.051
Summarised from the published abstract; every number is checked against it