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Effect of vericiguat on cardiovascular outcomes in patients with heart failure with and without diabetes: Insights from the VICTORIA trial

Title: Effect of vericiguat on cardiovascular outcomes in patients with heart failure with and without diabetes: Insights from the VICTORIA trial
Authors: Khan, S; Butler, J; Young, R; Lewis, B S; Escobedo, J; Refsgaard, J; Reyes, E; Roessig, L; Blaustein, R O; Lam, C S P; Voors, A A; Ponikowski, P; Anstrom, K J; Armstrong, P
Source: European Heart Journal ; volume 44, issue Supplement_2 ; ISSN 0195-668X 1522-9645
Publisher Information: Oxford University Press (OUP)
Publication Year: 2023
Description: Objective To investigate the impact of type 2 diabetes mellitus (T2D) on outcomes in patients with worsening heart failure with reduced ejection fraction (HFrEF) and to assess the efficacy of vericiguat in these patients. Methods Patients with HF and a left ventricular ejection fraction ≤45% were randomized to receive vericiguat or placebo in addition to standard therapy. The primary outcome was a composite of cardiovascular death or first hospitalization for HF (HHF). A Cox proportional hazards model was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) to assess if the effect of vericiguat differed by history of T2D. Results Of the 5048 patients, 2369 (46.9%) had T2D. The risks of the primary outcome, HHF, and all-cause and cardiovascular death were already very high in those without T2D and even higher in patients with T2D. The beneficial effect of vericiguat on the primary outcome did not differ in patients with (HR, 0.91 [95% CI, 0.80–1.03]) or without (HR, 0.87 [95% CI, 0.76–0.99] (P-interaction = 0.64) T2D (Figure). No significant differences were noted among patients with and without T2D with respect to the effect of vericiguat on HHF and all-cause or cardiovascular death. Conclusion Notwithstanding the increased incidence of cardiovascular death and HHF conferred by T2D, in this post-hoc analysis of VICTORIA, vericiguat compared with placebo significantly reduced the risk of cardiovascular death or HHF in patients with worsening HFrEF regardless of T2D status.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/eurheartj/ehad655.810
Availability: https://doi.org/10.1093/eurheartj/ehad655.810; https://academic.oup.com/eurheartj/article-pdf/44/Supplement_2/ehad655.810/53602744/ehad655.810.pdf
Rights: https://academic.oup.com/pages/standard-publication-reuse-rights
Accession Number: edsbas.483F7212
Database: BASE