Vericiguat and hypotension in patients with heart failure and reduced ejection fraction: VERIFY-HF registry

IF 3.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal Pub Date : 2026-02-01 Epub Date: 2025-09-22 DOI:10.1016/j.ahj.2025.09.013

Shingo Matsumoto MD, PhD , Takahito Nasu MD, PhD , Wataru Fujimoto MD, PhD , Nobuyuki Kagiyama MD, PhD , Yasuyuki Shiraishi MD, PhD , Shunsuke Ishii MD, PhD , Takeshi Ijichi MD, PhD , Gaku Nakazawa MD, PhD , Takanori Ikeda MD, PhD , Koshiro Kanaoka MD, PhD

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引用次数: 0

Abstract

Background

Real-world characteristics and outcomes in patients with heart failure (HF) and reduced ejection fraction (HFrEF) treated with vericiguat remain unclear. We investigated patient characteristics, hypotension—the most relevant clinical event—, and outcomes after initiating vericiguat in patients with HFrEF.

Methods

In this nationwide, multicentre retrospective study involving 22 hospitals in Japan, we examined symptomatic or asymptomatic hypotension and drug discontinuation within 90 days after initiation of vericiguat in patients with left ventricular ejection fraction <45%. The association between hypotension and HF outcomes was also examined.

Results

Among the 799 patients with HFrEF, the mean age was 69.6 years, and 218 (27.3%) were female. Of them, 316 (39.5%) had New York Heart Association classification III or IV, and 329 (41.8%) had systolic blood pressure (sBP) <100 mm Hg. Hypotension was observed in 25.3% of patients within 90 days, with asymptomatic hypotension being the most common (17.9%). By contrast, drug discontinuation related to hypotension was less frequent (4.4%). After adjustment, sBP <100 mm Hg, low body mass index, and in-hospital vericiguat initiation were associated with the incidence of hypotension within 90 days. Patients who experienced hypotension had a greater risk of cardiovascular death or HF hospitalization than those who did not (P = .01).

Conclusions

Although hypotension was relatively common soon after starting vericiguat, they were not often associated with drug discontinuation. Patients experiencing hypotension had a greater risk of HF outcomes, but this would be primarily associated with their vulnerability, given the infrequent discontinuation.

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心力衰竭和射血分数降低患者的眩晕和低血压：VERIFY-HF登记。

背景：使用vericiguat治疗心力衰竭（HF）和射血分数降低（HFrEF）患者的真实世界特征和结果尚不清楚。我们调查了HFrEF患者的患者特征、低血压（最相关的临床事件）和开始验证后的结果。方法：在这项涉及日本22家医院的全国性多中心回顾性研究中，我们检查了左室射血分数患者在开始使用vericiguat后90天内出现症状或无症状低血压和停药的情况。结果：799例HFrEF患者中，平均年龄为69.6岁，218例（27.3%）为女性。其中316例（39.5%）患有纽约心脏协会（NYHA） III或IV级，329例（41.8%）有收缩压（sBP）。结论：虽然在开始vericiguat后不久出现低血压相对常见，但它们通常与停药无关。低血压患者发生HF的风险更大，但这主要与他们的易感性有关，因为停药的情况并不频繁。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American heart journal 医学-心血管系统

CiteScore

8.20

自引率

2.10%

发文量

214

审稿时长

38 days

期刊介绍： The American Heart Journal will consider for publication suitable articles on topics pertaining to the broad discipline of cardiovascular disease. Our goal is to provide the reader primary investigation, scholarly review, and opinion concerning the practice of cardiovascular medicine. We especially encourage submission of 3 types of reports that are not frequently seen in cardiovascular journals: negative clinical studies, reports on study designs, and studies involving the organization of medical care. The Journal does not accept individual case reports or original articles involving bench laboratory or animal research.