Over the past decade, the number of therapies for heart failure (HF) with clinical
trial evidence of benefit has multiplied. Physicians treating HF today are faced with
the challenges of selecting and prioritizing among drugs to optimize therapy for each
patient. The current paradigm centers around four first-line therapies—beta blockers,
angiotensin-receptor-neprilysin inhibitors, mineralocorticoid-receptor antagonists
and sodium–glucose cotransporter 2 (SGLT2) inhibitors—that showed the largest relative
effects in broad patient populations (
1
). Therapies targeting nitric oxide (NO) signaling such as soluble guanylyl cyclase
(sGC) stimulator vericiguat have also shown benefits in randomized trials (
2
), but have not been included in first line HF with reduced ejection fraction (HFrEF)
treatment recommendations. The current one-size-fits-all clinical guidelines for HF
provide little direction on tailoring therapies to individual patients.To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
March 6,
2023
Received:
March 6,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Inc.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Assessment of Biomarkers of Myocardial injury, Inflammation, and Renal Function in Heart Failure With Reduced Ejection Fraction: The VICTORIA Biomarker SubstudyJournal of Cardiac Failure
- PreviewWe evaluated 5 blood tests that evaluate heart injury (cardiac troponin T [cTnT]), inflammation, and renal function for associations with outcomes and efficacy of treatment with the drug vericiguat in the VICTORIA study of patients with HFrEF. Higher baseline levels of a measure of cTnT and two measures of inflammation were associated with the primary outcome of cardiovascular death or HF hospitalization. Lower levels of cTnT identified patients when treated with vericiguat had a lower risk of cardiovascular death, but not HF hospitalization versus placebo.
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