Heart failure & cardiomyopathies

Recurrent Hospitalizations and Response to Vericiguat in Heart Failure and Reduced Ejection Fraction

JACC Heart FailPublished Secondary analysis of the VICTORIA randomised trial

Authors' conclusion

Additional investigation of the association between vericiguat and cardiovascular death and total HF hospitalizations by recurrent event analysis did not show a statistically significant reduction in events. Mortality was high after HF hospitalization

Study context

Population
Patients with HFrEF in the VICTORIA trial
Participants
2,526 vs 2,524
Comparison
Vericiguat vs placebo
  • Vericiguatn = 2,526
  • Placebon = 2,524reference
Primary endpoint
Total HF hospitalizations and CV death (recurrent events)
Methodological detailsrecurrent event analysis (Andersen-Gill)
  • Recurrent event analysis (Andersen-Gill)

Primary result

As reported in the abstract

Total HF hospitalizations and CV deaths

Vericiguat

1,222

events

Placebo

1,336

events

Vericiguat vs PlaceboHazard ratio (95% CI)
Unadjusted
0.89(0.81–0.97)
Adjusted for VICTORIA model covariates
0.92(0.84–1.01)

Further findings

OutcomeAdjusted HR (95% CI)
Total HF hospitalizations and CV deaths, by baseline NT-proBNP quartile (subgroup)Q10.80 (0.64–1.01)
Total HF hospitalizations and CV deaths, by baseline NT-proBNP quartile (subgroup)Q20.77 (0.62–0.94)
Total HF hospitalizations and CV deaths, by baseline NT-proBNP quartile (subgroup)Q31.12 (0.93–1.34)
Total HF hospitalizations and CV deaths, by baseline NT-proBNP quartile (subgroup)Q40.87 (0.74–1.04)

All-cause mortality after HF hospitalization (events per 100 patient-years)

Total heart failure (HF) hospitalizations and CV deaths, by baseline NT-proBNP quartile (subgroup)

Suggestion of benefit with NT-proBNP ≤2,816 pg/mL (Q1 and Q2)

Treatment effect by prior HF hospitalization

No significant difference in treatment effect between patients with vs without an HF hospitalization

Original publication

Recurrent Hospitalizations and Response to Vericiguat in Heart Failure and Reduced Ejection Fraction. JACC Heart Fail. Published 14 February 2024. doi:10.1016/j.jchf.2023.12.005

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