Vericiguat en el abordaje actual del paciente con insuficiencia cardiaca

In patients with heart failure and reduced ejection fraction (HFrEF), experiencing heart failure (HF) decompensation represents a true turning point in the evolution of this condition, as it indicates progression of the disease, and is associated with a high risk of death and early hospitalization for HF. Alteration of the soluble nitric oxide-guanylate cyclase pathway plays a fundamental role in the etiopathogenesis and development of HFrEF. Vericiguat is an oral stimulator of the soluble nitric oxide-guanylate cyclase that allows restoring this system. The VICTORIA study was the first large clinical trial to include patients with HFrEF and recent HF decompensation, showing the beneficial effects of adding vericiguat to standard treatment. In the present work, the evidence on this drug is reviewed and a proposal for its practical management is presented. Its good safety profile, as well as the simplicity of its use, will facilitate its implementation in real life.