Background Medical Therapy and Clinical Outcomes From the VICTORIA Trial

In this secondary analysis of the VICTORIA trial published in Circulation: Heart Failure, researchers investigated if the primary composite outcome of cardiovascular death or heart failure (HF) hospitalization was related to variations in background use and dosing of guideline-directed medical therapy in patients with HF with reduced ejection fraction (HFrEF), a condition in which the heart is unable to pump out blood effectively.

Of the 5,050 patients enrolled in VICTORIA, 5,040 (99.8%) had medication data at their first study visit. The researchers evaluated patient adherence to guideline use of angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, angiotensin receptor-neprilysin inhibitors, beta-blockers, and mineralocorticoid receptor antagonists.

Their findings indicate that patients in the VICTORIA trial were well treated with medications for HFrEF. The effectiveness of vericiguat, a drug used to reduce the risk of cardiovascular death and hospitalization in patients with chronic HF, remained consistent regardless of the presence of background use of guideline-directed medical therapies, even after adjusting and accounting for patient factors.

Vericiguat proved beneficial in reducing the risk of hospitalization or cardiovascular death when it was utilized on top of existing background medical therapy. As such, the researchers advise that vericiguat be considered as a simultaneous treatment option for patients with a recent HF hospitalization or emergency department visit, in addition to background pharmacological treatment, such as triple or quadruple therapy.

This research was conducted by the VICTORIA study group, and CVC co-authors include Drs. Justin Ezekowitz, Cynthia Westerhout, and Paul Armstrong.