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A Systematic Review of the Effect of Vericiguat on Patients with Heart Failure
Despite recent advances in heart failure (HF) therapy, the risk of cardiovascular (CV) mortality, morbidity, and HF hospitalization (HFH) are major challenges in HF treatment. We aimed to review the potential of vericiguat as a treatment option for HF. A systematic literature review was performed us...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380763/ https://www.ncbi.nlm.nih.gov/pubmed/37511587 http://dx.doi.org/10.3390/ijms241411826 |
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author | Sahana, Urjosee Wehland, Markus Simonsen, Ulf Schulz, Herbert Grimm, Daniela |
author_facet | Sahana, Urjosee Wehland, Markus Simonsen, Ulf Schulz, Herbert Grimm, Daniela |
author_sort | Sahana, Urjosee |
collection | PubMed |
description | Despite recent advances in heart failure (HF) therapy, the risk of cardiovascular (CV) mortality, morbidity, and HF hospitalization (HFH) are major challenges in HF treatment. We aimed to review the potential of vericiguat as a treatment option for HF. A systematic literature review was performed using the PubMed database and ClinicalTrials.gov. Four randomized controlled trials were identified, which study the safety and efficacy of vericiguat in HF patients. Vericiguat activates soluble guanylate cyclase (sGC) by binding to the beta-subunit, bypassing the requirement for NO-induced activation. The nitric oxide (NO)–sGC–cyclic guanosine monophosphate (cGMP) pathway plays an essential role in cardiovascular (CV) regulation and the protection of healthy cardiac function but is impaired in HF. Vericiguat reduced the risk of CV death and HFH in HF patients with reduced ejection fraction (HFrEF) but showed no therapeutic effect on HF with preserved ejection fraction (HFpEF). The trials demonstrated a favorable safety profile with most common adverse events such as hypotension, syncope, and anemia. Therefore, vericiguat is recommended for patients with HFrEF and a minimum systolic blood pressure of 100 mmHg. Treatment with vericiguat is considered when the individual patient experiences decompensation despite being on guideline-recommended medication, e.g., angiotensin-converting inhibitor/AT1 receptor antagonist, beta-adrenoceptor antagonist, spironolactone, and sodium-glucose transporter 2 inhibitors. Furthermore, larger studies are required to investigate any potential effect of vericiguat in HFpEF patients. Despite the limitations, vericiguat can be recommended for patients with HFrEF, where standard-of-care is insufficient, and the disease worsens. |
format | Online Article Text |
id | pubmed-10380763 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-103807632023-07-29 A Systematic Review of the Effect of Vericiguat on Patients with Heart Failure Sahana, Urjosee Wehland, Markus Simonsen, Ulf Schulz, Herbert Grimm, Daniela Int J Mol Sci Review Despite recent advances in heart failure (HF) therapy, the risk of cardiovascular (CV) mortality, morbidity, and HF hospitalization (HFH) are major challenges in HF treatment. We aimed to review the potential of vericiguat as a treatment option for HF. A systematic literature review was performed using the PubMed database and ClinicalTrials.gov. Four randomized controlled trials were identified, which study the safety and efficacy of vericiguat in HF patients. Vericiguat activates soluble guanylate cyclase (sGC) by binding to the beta-subunit, bypassing the requirement for NO-induced activation. The nitric oxide (NO)–sGC–cyclic guanosine monophosphate (cGMP) pathway plays an essential role in cardiovascular (CV) regulation and the protection of healthy cardiac function but is impaired in HF. Vericiguat reduced the risk of CV death and HFH in HF patients with reduced ejection fraction (HFrEF) but showed no therapeutic effect on HF with preserved ejection fraction (HFpEF). The trials demonstrated a favorable safety profile with most common adverse events such as hypotension, syncope, and anemia. Therefore, vericiguat is recommended for patients with HFrEF and a minimum systolic blood pressure of 100 mmHg. Treatment with vericiguat is considered when the individual patient experiences decompensation despite being on guideline-recommended medication, e.g., angiotensin-converting inhibitor/AT1 receptor antagonist, beta-adrenoceptor antagonist, spironolactone, and sodium-glucose transporter 2 inhibitors. Furthermore, larger studies are required to investigate any potential effect of vericiguat in HFpEF patients. Despite the limitations, vericiguat can be recommended for patients with HFrEF, where standard-of-care is insufficient, and the disease worsens. MDPI 2023-07-23 /pmc/articles/PMC10380763/ /pubmed/37511587 http://dx.doi.org/10.3390/ijms241411826 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Sahana, Urjosee Wehland, Markus Simonsen, Ulf Schulz, Herbert Grimm, Daniela A Systematic Review of the Effect of Vericiguat on Patients with Heart Failure |
title | A Systematic Review of the Effect of Vericiguat on Patients with Heart Failure |
title_full | A Systematic Review of the Effect of Vericiguat on Patients with Heart Failure |
title_fullStr | A Systematic Review of the Effect of Vericiguat on Patients with Heart Failure |
title_full_unstemmed | A Systematic Review of the Effect of Vericiguat on Patients with Heart Failure |
title_short | A Systematic Review of the Effect of Vericiguat on Patients with Heart Failure |
title_sort | systematic review of the effect of vericiguat on patients with heart failure |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380763/ https://www.ncbi.nlm.nih.gov/pubmed/37511587 http://dx.doi.org/10.3390/ijms241411826 |
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