Highlights of ESC HF 2021 - Insights from the VICTORIA trial (VerICiguaT global study in subjects with HFrEF)

Vericiguat in patients with atrial fibrillation and heart failure with reduced ejection fraction: Insights from the VICTORIA (VerICiguaT global study in subjects with HFrEF)  As we know, Heart failure is associated with impaired synthesis of Nitric Oxide and decreased activity of soluble Guanylate Cyclase (sGC), which may contribute to myocardial and vascular dysfunction. By directly stimulating soluble Guanylate Cyclase, independently of and synergistically with Nitric Oxide, Vericiguat augments levels of intracellular cGMP, leading to smooth muscle relaxation and vasodilation. AF is a common arrhythmia involved with Heart Failure and complicating factor for HF with reduced ejection fraction. The effect of some guideline-based treatments may differ according to whether AF is present or not. In the VICTORIA trial, 45% had HF with Atrial fibrillation and the objective was to determine the relationship of AF with outcomes of Vericiguat treatment. The trial also assessed the occurrence of new-onset AF post-randomization The result showed that there was no association of AF with Primary outcomes, CV death, and Hospitalization for Heart Failure in patients on Vericiguat treatment. Over median follow-up of 10 months, new-onset AF was seen in 10%, among them, 6% has no prior AF and 18% has intermittent AF. The incidence of new-onset AF did not differ among patients receiving placebo and Vericiguat. Thus the study concluded that nearly half of patients with HF with reduced ejection fraction and decompensated Heart Failure had Atrial Fibrillation. Patients with intermittent AF had worse outcomes with new onset of AF in less than a year. The beneficial effect of Vericiguat was unaffected by any of AF at baseline. Disclaimer: Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the ­­­STAR UPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.