# Vericiguat-voordeel geprojecteerd op PARADIGM-HF en DAPA-HF populaties

*geplaatst 2025-04-01 · Hartfalen · ESC heart failure · doi 10.1002/ehf2.15134 · https://hartvaat.nl/2025/04/01/vericiguat-voordeel-geprojecteerd-op-paradigm-hf-en-dapa-hf-populaties/*

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.

## English: Projecting the benefit of vericiguat in PARADIGM-HF and DAPA-HF populations: Insights from the VICTORIA trial.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: ESC heart failure, https://doi.org/10.1002/ehf2.15134. Bijgewerkt 2026-07-03T13:30:34Z. 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.