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Vericiguat treatment of heart failure: A systematic review and meta-analysis
Heng Yang1, Chao Luo1, Wan-Qi Lan1
1Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330008, Jiangxi Province, China.
Insights
Vericiguat (10 mg) effectively treats chronic heart failure by reducing hospitalizations and cardiovascular events. This meta-analysis confirms its efficacy and favorable safety profile compared to placebo.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Heart failure (HF) represents a significant global health and economic burden.
- Vericiguat is an emerging therapeutic agent for HF management.
Purpose of the Study:
- To conduct a meta-analysis evaluating the efficacy and safety of Vericiguat in chronic heart failure patients.
- To synthesize data from randomized controlled trials (RCTs) to assess Vericiguat's impact on key clinical outcomes.
Main Methods:
- Comprehensive literature search of PubMed, EMBASE, Web of Science, and Cochrane Library up to March 2023.
- Inclusion of four RCTs involving 5919 patients, with independent data extraction and quality assessment.
- Meta-analysis performed using RevMan5.4 to pool data and assess treatment effects.
Main Results:
- Vericiguat (10 mg) significantly reduced the primary endpoint (cardiovascular mortality or HF hospitalization) (RR=0.91, P=0.01) and HF hospitalizations (RR=0.92, P=0.05).
- No significant differences were observed in cardiovascular death, all-cause death, blood pressure, heart rate, or quality of life scores.
- Vericiguat demonstrated a comparable safety profile to placebo, with non-significant trends towards increased symptomatic hypotension and syncope.
Conclusions:
- Vericiguat (10 mg) demonstrates superior efficacy over placebo in managing chronic heart failure.
- The drug exhibits a favorable safety profile, making it a viable treatment option for patients with chronic heart failure.
Background:
Heart failure (HF), an end-stage manifestation of various cardiac diseases, poses an enormous economic and health burden on society. Vericiguat may be an effective drug in the treatment of HF.
Aim:
To explore by meta-analysis the efficacy and safety of Vericiguat in treating chronic heart failure.
Methods:
Databases, including PubMed, EMBASE, Web of Science, and Cochrane Library, were searched to collect all published randomized controlled trials (RCTs) on Vericiguat treatment of chronic heart failure from the earliest electronic records to those published in March 2023. Two investigators independently screened the literature according to inclusion and exclusion criteria, evaluated the quality of the studies, and extracted valid data before conducting a meta-analysis using RevMan5.4.
Results:
Four RCTs with 5919 patients were included, and the meta-analysis showed that treatment with 10 mg Vericiguat reduced the incidence of the primary endpoint (a composite of cardiovascular mortality and first heart-failure-related hospitalization) in patients with chronic heart failure compared to placebo [relative risk (RR) = 0.91, 95% confidence interval (CI): 0.85-0.98, P = 0.01], and reduced the incidence of heart-failure-related hospitalization (RR = 0.92, 95%CI: 0.84-1.00, P = 0.05). However, for the incidence of cardiovascular and all-cause death, there were no significant differences between the Vericiguat and placebo groups. In addition, the two groups did not show significant differences in blood pressure, heart rate, and Kansas Cardiomyopathy Questionnaire physical limitation score. In terms of safety, 10 mg Vericiguat did not increase the risk of adverse effects in patients with chronic heart failure. Vericiguat may increase the risk of symptomatic hypotension (RR = 1.17, 95%CI: 0.98-1.39, P = 0.08) and syncope (RR = 1.18, 95%CI: 0.90-1.55, P = 0.24), but not significantly.
Conclusion:
Vericiguat (10 mg) was more effective than placebo in treating patients with chronic heart failure and had a better safety profile.
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