New to MyHealth?
Manage Your Care From Anywhere.
Access your health information from any device with MyHealth. You can message your clinic, view lab results, schedule an appointment, and pay your bill.
ALREADY HAVE AN ACCESS CODE?
DON'T HAVE AN ACCESS CODE?
NEED MORE DETAILS?
MyHealth for Mobile
Soluble Guanylate Cyclase Stimulators in Patients with Heart Failure with Reduced Ejection Fraction Across the Risk Spectrum.
Soluble Guanylate Cyclase Stimulators in Patients with Heart Failure with Reduced Ejection Fraction Across the Risk Spectrum. European journal of heart failure Butler, J., Usman, M. S., Anstrom, K. J., Blaustein, R. O., Bonaca, M. P., Ezekowitz, J. A., Freitas, C., Lam, C. S., Lewis, E. F., Lindenfeld, J., McMullan, C. J., Mentz, R. J., O'Connor, C., Rosano, G. M., Saldarriaga, C. I., Senni, M., Udelson, J., Voors, A. A., Zannad, F. 2022Abstract
Patients with heart failure with reduced ejection fraction (HFrEF) have a high residual risk of adverse outcomes, even when treated with optimal guideline-directed medical therapy and in a clinically stable state. Sodium guanylate cyclase (sGC) stimulators have the potential to lower this risk by modifying the nitric oxide-sGC-cyclic guanosine monophosphate cascade - a pathophysiological pathway that has been targeted with limited success in HFrEF previously. Vericiguat, an sGC stimulator, was shown to improve outcomes in patients with HFrEF in the VICTORIA (A Study of Vericiguat in Participants With Heart Failure With Reduced Ejection Fraction) trial. However, this trial included patients with recently worsening disease. In this brief review, we discuss the rationale of evaluating sGC stimulators in lower-risk HFrEF patients. First, all key HFrEF medications have been evaluated in both higher and lower-risk populations, and the treatment effect is not always consistent across the risk spectrum. Second, preclinical studies and post-hoc studies of the VICTORIA trial have suggested that sGC stimulators may have cardioprotective effects - these effects may be more apparent when the medication is initiated earlier in the disease process. Third, the effect of vericiguat on cardiovascular mortality remains uncertain and a trial with a longer follow-up in a lower-risk population may allow better assessment of its effect on cardiovascular mortality. Therefore, there is a pertinent need to investigate the effects of vericiguat in optimally-treated, low-risk HFrEF patients (i.e., those without recent worsening heart failure). This article is protected by copyright. All rights reserved.
View details for DOI 10.1002/ejhf.2720
View details for PubMedID 36250238