Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Sahana, Urjosee, Wehland, Markus, Simonsen, Ulf, Schulz, Herbert, Grimm, Daniela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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
_version_ 1785080276237418496
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
work_keys_str_mv AT sahanaurjosee asystematicreviewoftheeffectofvericiguatonpatientswithheartfailure
AT wehlandmarkus asystematicreviewoftheeffectofvericiguatonpatientswithheartfailure
AT simonsenulf asystematicreviewoftheeffectofvericiguatonpatientswithheartfailure
AT schulzherbert asystematicreviewoftheeffectofvericiguatonpatientswithheartfailure
AT grimmdaniela asystematicreviewoftheeffectofvericiguatonpatientswithheartfailure
AT sahanaurjosee systematicreviewoftheeffectofvericiguatonpatientswithheartfailure
AT wehlandmarkus systematicreviewoftheeffectofvericiguatonpatientswithheartfailure
AT simonsenulf systematicreviewoftheeffectofvericiguatonpatientswithheartfailure
AT schulzherbert systematicreviewoftheeffectofvericiguatonpatientswithheartfailure
AT grimmdaniela systematicreviewoftheeffectofvericiguatonpatientswithheartfailure