Research progress of vericiguat in treatment of patients with heart failure

Heart failure (HF) remains a major burden, with many patients facing a considerable risk of death or recurrent hospitalization. Vericiguat, a novel oral soluble guanylate cyclase (sGC) stimulator, increases the activity of the second messenger cyclic guanosine monophosphate (cGMP), which is involved in regulation of protective cardiovascular actions with a reduction in HF-related inflammation and oxidative stress and endothelial dysfunction. Two main clinical randomized control trials (RCTs), the SOCRATES-REDUCED phase Ⅱ study and the VICTORIA phase Ⅲ study, found that vericiguat is safe, well-tolerated, and effective with an absolute event-rate reduction in patients affected by HF with reduced ejection fraction (HFrEF) and recent cardiac decompensation. In patients with preserved ejection fraction (HFpEF), the SOCRATES-PRESERVED trial and the VITALITY trial demonstrated an improvement in quality of life and health status, but with a limited effect on prognosis. Further clinical trials of vericiguat are needed to determine the potential role of this drug for patients with chronic HF. This article will review the therapeutic effect, the mechanism and the evidence-based medicine of vericiguat in HFrEF and HFpEF.