Introduction: The Evolution of Vericiguat in Heart Failure Management
The management of heart failure with reduced ejection fraction (HFrEF) has undergone a revolutionary shift over the last decade. With the establishment of the four pillars of therapy—beta-blockers, ACE inhibitors/ARBs/ARNIs, mineralocorticoid receptor antagonists (MRAs), and SGLT2 inhibitors—clinicians have more tools than ever to improve survival. However, residual risk remains high, particularly following episodes of worsening heart failure. Vericiguat, a soluble guanylate cyclase (sGC) stimulator, was first validated in the VICTORIA trial, which focused on high-risk patients with a recent worsening event. The VICTOR trial was designed to extend these findings to a broader, more stable, and contemporary cohort of ambulatory HFrEF patients. The results, recently published in The Lancet and further analyzed in the Journal of the American College of Cardiology, provide a nuanced look at the drug’s efficacy and the changing landscape of heart failure monitoring.
