{"id":"56c494174ca0","type":"article","url":"https://hartvaat.nl/2025/04/01/vericiguat-voordeel-geprojecteerd-op-paradigm-hf-en-dapa-hf-populaties/","title":"Vericiguat-voordeel geprojecteerd op PARADIGM-HF en DAPA-HF populaties","title_en":"Projecting the benefit of vericiguat in PARADIGM-HF and DAPA-HF populations: Insights from the VICTORIA trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"ESC heart failure","doi":"10.1002/ehf2.15134","source_url":"https://doi.org/10.1002/ehf2.15134","authors":["Veraprapas Kittipibul","Robert J Mentz","Rebecca Young","Javed Butler","Justin A Ezekowitz","Carolyn S P Lam","Piotr Ponikowski","Adriaan Voors","Stefano Corda","Ciaran McMullan","Christopher M O'Connor","Kevin J Anstrom","Paul W Armstrong"],"significance":5,"published":"2025-04-01","source_date":"2025-04-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/hfref-hartfalen-met-verminderde-ejectie/","https://hartvaat.nl/kennis/hartfalen/esc-richtlijn-hartfalen-2021/"],"congress":"","summary_en":"This analysis projected the potential benefit of vericiguat onto simulated PARADIGM-HF and DAPA-HF populations. The estimated additional benefit over existing guideline-directed therapy supports vericiguat as a fifth pillar in the treatment of severe heart failure.","created":"2026-07-03T10:31:33Z","updated":"2026-07-03T13:30:34Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Analyse projecteerde het potentiële voordeel van vericiguat op de PARADIGM-HF en DAPA-HF populaties. Het geschatte additionele voordeel boven bestaande therapie ondersteunt de vijfde pijler bij ernstig hartfalen.","abstract_original":"AIMS: The VICTORIA trial demonstrated a significant reduction in the primary composite outcome of heart failure (HF) hospitalization or cardiovascular death with vericiguat relative to placebo in high-risk HF. This study aimed to contextualize treatment effects of vericiguat in populations with varying risk profiles simulated from the PARADIGM-HF and DAPA-HF trials. METHODS: Subgroups of VICTORIA participants (n = 5050) were generated to simulate PARADIGM-HF and DAPA-HF trial populations. The PARADIGM-HF-eligible population excluded participants not meeting left ventricular ejection fraction (LVEF), estimated glomerular filtration rate (eGFR), and minimal dose criteria and those with high predicted probability of run-in failure. The DAPA-HF-eligible population excluded those not meeting LVEF and eGFR criteria or with recent (<30 days) HF hospitalization. The time-to-first-event analysis was performed using an unadjusted Cox proportional hazards model. RESULTS: A total of 1982 (39.2%) and 2543 (50.4%) VICTORIA participants were respectively deemed eligible for PARADIGM-HF and DAPA-HF. Vericiguat was associated with numerically larger reductions in the primary outcome of HF hospitalization or cardiovascular death in populations simulated from PARADIGM-HF [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.72-0.99] and DAPA-HF (HR 0.82, 95% CI 0.71-0.94) compared with the overall VICTORIA trial (HR 0.90). Significant reduction in HF hospitalization with vericiguat was also observed in the DAPA-HF-eligible population (HR 0.83, 95%CI 0.73-0.95) and with a nominal reduction in the PARADIGM-HF-eligible population (HR 0.86, 95% CI 0.74-1.01). CONCLUSIONS: A trend towards enhanced efficacy of vericiguat in populations simulated from PARADIGM-HF and DAPA-HF was observed. These findings support further exploration of vericiguat in lower-risk HF populations as is being investigated in the ongoing VICTOR (a study of vericiguat in participants with chronic heart failure with reduced ejection fraction) trial."}