Vericiguat for the Treatment of Coronary Vasospasm (ViVA)): A Double-Blind Placebo-Controlled Randomized Crossover Trial
Authors' conclusion
The ViVA (Vericiguat in Vasospastic Angina) trial did not demonstrate evidence of improved peripheral vasodilator function or anginal symptoms in patients with coronary vasospasm.
Study context
- Population
- Angina with nonobstructive coronary arteries (ANOCA) patients with epicardial and/or microvascular vasospasmcrossover
- Participants
- 57 patients
- Comparison
- Vericiguat vs placebo
- Primary endpoint
- Peripheral vasodilator function during acetylcholine iontophoresis (laser speckle contrast analysis); daily angina episodes via the ORBITA-app
Methodological detailsdouble-blind, placebo-controlled, crossover
- Double-blind
- Placebo-controlled
- Crossover
Primary result
As reported in the abstract
Vericiguat vs PlaceboOdds ratio (95% CI)
Final-day OR for reduction in angina episodes; posterior probability of benefit 0.07
0.84(0.65–1.04)
- Peripheral vasodilator function, AUC
- intervention effect estimate −1,221 arbitrary perfusion units•seconds (95% CI −4,237 to 1,796); P = 0.42
Further findings
Episode counts and angina-free days · 70 days
- Similar between arms
Safety
Tolerability
- Treatment-related serious adverse events
- 0
- Modest reductions in BP; no clinically relevant laboratory abnormalities
Original publication
Vericiguat for the Treatment of Coronary Vasospasm (ViVA)): A Double-Blind Placebo-Controlled Randomized Crossover Trial. J Am Coll Cardiol. Published 28 August 2026. doi:10.
Summarised from the published abstract; every number is checked against it