Summary

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• This summary is based on the review of nine systematic review(s)/meta-analysis(es). ^[1-9]
• Vericiguat significantly reduced the incidence of the primary endpoint (a composite of cardiovascular mortality and first heart-failure-related hospitalization) in patients with chronic heart failure with left ventricular ejection fraction (LVEF) < 45%, showing a relative risk (RR) of 0.91 (95% confidence interval (CI): 0.85–0.98, P = 0.01), but it showed no effect in patients with LVEF ≥ 45%.
• Vericiguat reduced the risk of heart-failure-related hospitalization with an relative risk (RR) of 0.92 (95% CI: 0.84–1.00, P = 0.05), although it was less effective compared to sodium-glucose cotransporter-2 (SGLT2) inhibitors, which had a superior impact on reducing heart-failure hospitalization and the composite endpoint of cardiovascular death or hospitalization.
• There was no significant impact of vericiguat on cardiovascular mortality (RR 0.94; 95% CI: 0.83–1.06, P = 0.29) or all-cause mortality (RR 0.96; 95% CI: 0.86–1.07, P = 0.45).
• Vericiguat was generally well tolerated with no significant difference in the total serious adverse events between vericiguat and placebo (RR 0.96; 95% CI 0.89 to 1.03). Common adverse events included hypotension, syncope, and anemia, though these were not statistically significant compared to placebo.
• A slightly increased but not statistically significant risk of symptomatic hypotension (RR = 1.17, 95% CI 0.98-1.39) and syncope (RR = 1.18, 95% CI 0.90-1.55) was observed with vericiguat compared to placebo.
• Patients with high N-terminal pro B-type natriuretic peptide (NT-proBNP) levels (upper quartile) and those with heart failure with preserved ejection fraction (HFpEF) did not experience significant benefits from vericiguat compared to placebo, particularly in terms of cardiovascular mortality and hospitalization outcomes.