Patel Pushpraj, Mishra Anjeney, Gawande Sachin Madhavrao, Patel Akhilesh, Varshney Amit
Department of Cardiology, Golden Heart Hospital, Jabalpur, Madhya Pradesh, India.
Department of General Medicine, Noida International Institute of Medical Sciences, Gautam Budh Nagar, Uttar Pradesh, India.
J Pharm Bioallied Sci. 2024 Dec;16(Suppl 4):S4010-S4012. doi: 10.4103/jpbs.jpbs_1392_24. Epub 2024 Dec 27.
Heart failure (HF) with reduced ejection fraction (EF) poses high morbidity and mortality. Guidelines Directed Medical Therapy (GDMT) is essential, yet many patients experience significant symptoms. Vericiguat, a soluble guanylate cyclase stimulator, may serve as an adjunctive therapy by enhancing the nitric oxide (NO)-sGC-cyclic guanosine monophosphate (cGMP) pathway.
This observational cohort study involved 100 participants with stage C HF and reduced EF (<40%), divided into two groups: 48 receiving vericiguat plus GDMT and 52 receiving GDMT alone. Primary outcomes included mortality, HF admissions, and changes in EF over 6 months.
Mortality rates were lower in the vericiguat group (10.4%) than in GDMT alone (17.3%, = 0.32). HF admissions were reduced in the vericiguat group (25.0% vs 38.5%, < 0.14), with significantly fewer mean HF admissions per patient (0.7 vs 1.2, = 0.03). EF improved significantly more with vericiguat (+5.1% vs +2.3%, < 0.01).
Vericiguat may enhance management of stage C HF patients with reduced EF. Larger randomized controlled trials are needed to confirm these findings.
射血分数降低（EF）的心力衰竭（HF）具有高发病率和死亡率。指南指导的药物治疗（GDMT）至关重要，但许多患者仍有明显症状。维立西呱是一种可溶性鸟苷酸环化酶刺激剂，可通过增强一氧化氮（NO）-sGC-环磷酸鸟苷（cGMP）途径作为辅助治疗。
这项观察性队列研究纳入了100例C期HF且EF降低（<40%）的参与者，分为两组：48例接受维立西呱加GDMT，52例仅接受GDMT。主要结局包括死亡率、HF住院率以及6个月内EF的变化。
维立西呱组的死亡率（10.4%）低于仅接受GDMT组（17.3%，P = 0.32）。维立西呱组的HF住院率降低（25.0%对38.5%，P < 0.14），每位患者的平均HF住院次数显著减少（0.7对1.2，P = 0.03）。维立西呱治疗后EF改善更为显著（+5.1%对+2.3%，P < 0.01）。
维立西呱可能增强对C期EF降低的HF患者的管理。需要更大规模的随机对照试验来证实这些发现。
