Impact of Vericiguat on Outcomes Across Ejection Fraction in the VICTORIA Trial

Left ventricular ejection fraction (LVEF) measures the heart’s ability to pump blood out of the left ventricle, and can help determine if a patient is at risk for heart failure (HF). Published in JACC: Heart Failure, this study evaluated the relationship of LVEF with biomarker levels (markers within the body measuring the presence of a biological process or condition), risk of outcome, and if vericiguat, a drug used to reduce the risk of death and hospitalization in people with chronic HF, was uniformly effective across various levels of LVEF in the VICTORIA trial.

The study classified patients into three categories based on their LVEF levels at the beginning of the study. Within each subgroup, the researchers examined prespecified biomarkers, patient characteristics, clinical outcomes, and the effectiveness and safety of vericiguat.

The researchers found that in comparison to patients with a higher LVEF, those with a lower LVEF had a unique biomarker profile (characterized by signals indicating more cardiac wall stress and inflammation) and were at higher risk for poor clinical outcomes. Although vericiguat’s beneficial effect on cardiovascular death and HF hospitalizations did not significantly differ across the three LVEF levels, the researchers observed that the most significant marker of benefit was among patients in the lowest LVEF subgroup. These results will help guide how to best use vericiguat in high-risk patients with HF.   

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