<scp>VICTORIA</scp> in context

Dewan, Pooja; Jhund, Pardeep S.; McMurray, John J.V.

doi:10.1002/ejhf.1833

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…Furthermore, the primary event rate in the VICTORIA outpatient worsening subgroup (23.4 events per 100 patient-years) was more than 2 times higher than the corresponding rates in the lowest risk group of CHARM (those without prior HFH), and more similar to the event rates in the highest-risk CHARM group (those randomized 0-2 months following HFH) . The additional risk in the VICTORIA subgroups likely reflect the additive effects of the higher natriuretic peptide entry criteria and baseline levels as compared with prior trials . These results emphasize that patients with outpatient worsening HF (especially with elevated natriuretic peptides) are at significant risk of HFH and CV death comparable with that of HFH and should be strongly considered for additional disease-modifying therapies.…”

Section: Discussionmentioning

confidence: 72%

“…1 The additional risk in the VICTORIA subgroups likely reflect the additive effects of the higher natriuretic peptide entry criteria and baseline levels as compared with prior trials. 7,8 These results emphasize that patients with outpatient worsening HF (especially with elevated natriuretic peptides) are at significant risk of HFH and CV death comparable with that of HFH 9,10 and should be strongly considered for additional disease-modifying therapies. The benefit of vericiguat, added to standard guidelines-directed medical therapy, is particularly noteworthy in this setting, where a numerically greatest relative risk reduction with vericiguat was evident.…”

Section: Discussionmentioning

confidence: 85%

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Clinical Outcomes and Response to Vericiguat According to Index Heart Failure Event

et al. 2021

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The period following heart failure hospitalization (HFH) is a vulnerable time with high rates of death or recurrent HFH.OBJECTIVE To evaluate clinical characteristics, outcomes, and treatment response to vericiguat according to prespecified index event subgroups and time from index HFH in the Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction (VICTORIA) trial. DESIGN, SETTING, AND PARTICIPANTSAnalysis of an international, randomized, placebo-controlled trial. All VICTORIA patients had recent (<6 months) worsening HF (ejection fraction <45%). Index event subgroups were less than 3 months after HFH (n = 3378), 3 to 6 months after HFH (n = 871), and those requiring outpatient intravenous diuretic therapy only for worsening HF (without HFH) in the previous 3 months (n = 801). Data were analyzed between May 2, 2020, and May 9, 2020.INTERVENTION Vericiguat titrated to 10 mg daily vs placebo. MAIN OUTCOMES AND MEASURESThe primary outcome was time to a composite of HFH or cardiovascular death; secondary outcomes were time to HFH, cardiovascular death, a composite of all-cause mortality or HFH, all-cause death, and total HFH. RESULTS Among 5050 patients in the VICTORIA trial, mean age was 67 years, 24% were women, 64% were White, 22% were Asian, and 5% were Black. Baseline characteristics were balanced between treatment arms within each subgroup. Over a median follow-up of 10.8 months, the primary event rates were 40.9, 29.6, and 23.4 events per 100 patient-years in the HFH at less than 3 months, HFH 3 to 6 months, and outpatient worsening subgroups, respectively. Compared with the outpatient worsening subgroup, the multivariable-adjusted relative risk of the primary outcome was higher in HFH less than 3 months (adjusted hazard ratio, 1.48; 95% CI, 1.27-1.73), with a time-dependent gradient of risk demonstrating that patients closest to their index HFH had the highest risk. Vericiguat was associated with reduced risk of the primary outcome overall and in all subgroups, without evidence of treatment heterogeneity. Similar results were evident for all-cause death and HFH. Addtionally, a continuous association between time from HFH and vericiguat treatment showed a trend toward greater benefit with longer duration since HFH. Safety events (symptomatic hypotension and syncope) were infrequent in all subgroups, with no difference between treatment arms.CONCLUSIONS AND RELEVANCE Among patients with worsening chronic HF, those in closest proximity to their index HFH had the highest risk of cardiovascular death or HFH, irrespective of age or clinical risk factors. The benefit of vericiguat did not differ significantly across the spectrum of risk in worsening HF.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 85%

Clinical Outcomes and Response to Vericiguat According to Index Heart Failure Event

et al. 2021

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“…Exclusion criteria were ADHF, systolic blood pressure < 100 mmHg, eGFR < 15 mL/min/1.73 m 2 , concomitant use of long-acting nitrates or phosphodiesterase 5 inhibitors. The study enrolled a very high-risk population: most patients had NYHA class III-IV, and their NT-proBNP levels were higher than other RCTs [37]. Vericiguat reduced the primary outcome of CVD and HF hospitalization by 10%.…”

Section: Worsening Heart Failure: Is It Time To Adopt New Strategies ...mentioning

confidence: 99%

New Challenges in Heart Failure with Reduced Ejection Fraction: Managing Worsening Events

Lavalle,

Di Lullo,

Jabbour

et al. 2023

JCM

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Patients with an established diagnosis of heart failure (HF) with reduced ejection fraction (HFrEF) are prone to experience episodes of worsening symptoms and signs despite continued therapy, termed “worsening heart failure” (WHF). Despite guideline-directed medical therapy, worsening of chronic heart failure accounts for almost 50% of all hospital admissions for HF, and patients experiencing WHF carry a substantially higher risk of death and hospitalization than patients with “stable” HF. New drugs are emerging as arrows in the quiver for clinicians to address the residual risk of HF hospitalization and cardiovascular deaths in patients with WHF. This question-and-answer-based review will discuss the emerging definition of WHF in light of the recent clinical consensus released by the Heart Failure Association (HFA) of the European Society of Cardiology (ESC), the new therapeutic approaches to treat WHF and then move on to their timing and safety concerns (i.e., renal profile).

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Relative Efficacy of Sacubitril-Valsartan, Vericiguat, and SGLT2 Inhibitors in Heart Failure with Reduced Ejection Fraction: a Systematic Review and Network Meta-Analysis

Aimo

Pateras

Stamatelopoulos

et al. 2020

Cardiovasc Drugs Ther

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VICTORIA in context

Cited by 3 publications

References 29 publications

Clinical Outcomes and Response to Vericiguat According to Index Heart Failure Event

Clinical Outcomes and Response to Vericiguat According to Index Heart Failure Event

New Challenges in Heart Failure with Reduced Ejection Fraction: Managing Worsening Events

Relative Efficacy of Sacubitril-Valsartan, Vericiguat, and SGLT2 Inhibitors in Heart Failure with Reduced Ejection Fraction: a Systematic Review and Network Meta-Analysis

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