The results of the VICTOR trial were presented at the 2025 ESC Congress and simultaneously published in The Lancet. This large-scale, international, double-blind study enrolled over 6,000 patients with heart failure with reduced ejection fraction (HFrEF) whose condition had not recently worsened. Researchers, including the CVC’s Dr. Justin Ezekowitz, found that vericiguat did not meet the primary endpoint of reducing the composite risk of cardiovascular death or hospitalization for heart failure. However, a key secondary finding revealed a reduction in cardiovascular deaths among patients receiving vericiguat, suggesting the medication may still provide a mortality benefit for this patient population.
In addition to these initial findings, two concurrent secondary analyses provided further insights. A paper in the Journal of the American College of Cardiology found that vericiguat reduced the overall risk of worsening heart failure by accounting for both outpatient and inpatient events. This finding, along with the observed reduction in mortality, suggests the drug could potentially help reduce heart failure events in stable outpatients with HFrEF. A separate analysis, published in the European Heart Journal, found that for well-treated patients, vericiguat significantly lowered the risk of all-cause and cardiovascular-related death compared to a placebo. These findings, along with the drug’s established safety and tolerability, support its role as an effective addition to existing guideline-directed medical therapy for HFrEF patients.
Another noteworthy finding came from a pooled analysis that combined data from over 11,000 participants from the VICTOR trial and the earlier VICTORIA trial, which focused on HFrEF patients with recent worsening heart failure. This analysis, conducted by researchers including the CVC’s Dr. Ezekowitz and Dr. Paul Armstrong, was also presented at ESC and published in The Lancet. The study found that vericiguat reduced the risk of heart failure hospitalization and cardiovascular death across a wide range of patients with HFrEF, including those receiving current guideline-directed therapy. These results indicate that vericiguat could be an effective treatment option for specific patient populations across the entire HFrEF spectrum.
Dr. Armstrong, who served as Chair for the VICTORIA trial, notes: “It was very gratifying to witness live these two highly regarded presentations at a late breaking session at the ESC in Madrid earlier this month. Our prior work from VICTORIA (in which Justin Ezekowitz, Cindy Westerhout and Tracy Temple played a key role) informed the design of VICTOR. This proved to be prescient in identifying the large cohort of heart failure patients with NT-proBNP levels < 6000 pg/ml where clear evidence of benefit emerged on both mortality and heart failure hospitalization in the pooled analysis. Coupled with these two simultaneous publications in The Lancet, was an accompanying editorial by the Chairman of the ACC/AHA Heart Failure Guidelines Committee who signalled their relevance as a valuable addition to real-world clinical practice. I wish to especially provide a shout out to all members of the CVC team for their fine work: their contributions have both enriched our understanding of heart failure and, most importantly, advanced the care of thousands of heart failure patients world-wide.”
