Heart failure & cardiomyopathiesCohort study

One-year multicenter prospective real-world study of vericiguat effectiveness and safety in Spain

ESC Heart FailPublished

  • prospective, multicentre registry
  • consecutive patients
  • 41 centres in Spain

Authors' conclusion

Vericiguat added to optimized quadruple therapy was associated with reverse remodelling, reduced NT-proBNP, improved functional class, and a numerical reduction in HF-related events in real-world HFrEF patients. These findings confirm the clinical utility and safety of vericiguat in routine practice.

Study context

Population
Patients with heart failure and reduced ejection fraction (HFrEF) following recent decompensation initiating vericiguat in routine clinical practice in Spainconsecutive patients initiating vericiguat
Participants
835 patients

Main finding

As reported in the abstract

Quadruple therapy · 12 months

baseline

61.7%

12 months

63.0%

P

P = .526

Observational data: associations, not effects.

Further findings

OutcomeOR (95% CI)P value
Predictor of discontinuation: higher baseline NT-proBNP (per 1000-pg/ml increase) · independently predicted discontinuation1.06 (1.03–1.08)P < 0.001

NT-proBNP · 1-year follow-up

baseline
3532.0 (IQR: 1689.3-6974.5)
1 year
2291.5 pg/ml (IQR: 1063.0-5076.3)
P
P < 0.001

LVEF · 1-year follow-up

baseline
30.3% (SD: 7.6)
1 year
35.4% (SD: 11.1)
P
P < 0.001

NYHA class II patients · 1-year follow-up

baseline
55.6%
1 year
62.2%
P
P < 0.001

Mean HF decompensations requiring intravenous diuretics

preceding year
1.34 (SD: 1.1)
during follow-up
0.65 (SD: 1.3)

Non-HF cardiovascular hospitalizations

before
0.98 (SD: 1.4)
during follow-up
0.39 (SD: 1.0)

Baseline characteristics and therapy

age
71.3 years [SD: 11.2]
male
78.9%
SGLT2i
91.5%
beta-blockers
90.7%
RAASi
85.4%
MRAs
79.8%

Safety

Vericiguat discontinuation

discontinued
13.4%
of discontinuations, due to symptomatic hypotension
49.4%

Original publication

One-year multicenter prospective real-world study of vericiguat effectiveness and safety in Spain. ESC Heart Fail. Published 13 May 2026. doi:10.1093/eschf/xvag138

Summarised from the published abstract; every number is checked against it