Vericiguat in Chinese Patients with Heart Failure and Reduced Ejection Fraction: A Real-World Prospective Study

Vericiguat has been shown to improve clinical outcomes in patients with heart failure (HF) with reduced ejection fraction in several randomized controlled trials. However, there is limited real-world evidence regarding its effectiveness in clinical practice outside of the controlled research setting.

Patients hospitalized due to symptomatic HF between January 1 and December 30, 2023, were consecutively enrolled and divided into the vericiguat group and the control group. A total of 207 patients with left ventricular ejection fraction <45% were enrolled.

Patients in the control group had a higher incidence of clinical endpoints than the vericiguat group: cardiac mortality and hospitalization for symptomatic HF during the median follow-up duration of 11.25 months. Patients in the vericiguat group demonstrated a higher event-free survival rate for both cardiac mortality and hospitalization for HF. In the univariable Cox regression analysis, vericiguat was found to be associated with a reduced risk of cardiac mortality (hazard ratio [HR]: 0.299, 95% confidence interval [CI]: 0.104-0.863, p = 0.026) and hospitalization for HF (HR: 0.586, 95% CI: 0.348-0.988, p = 0.045). After propensity score matching for age and sex, we observed that vericiguat's benefit on cardiac mortality was maintained.

This prospective study is the first to report, using real-world data from a Chinese population with ventricular ejection fraction <45%, that vericiguat is associated with a lower incidence of clinical endpoints, including cardiac mortality and hospitalization for HF. These findings align with the results of previous clinical trials.