{"id":"5f4ef4132cc7","type":"article","url":"https://hartvaat.nl/2026/05/13/verisec-register-vericiguat-halveert-hartfalen-decompensaties-bij-hfref-in-dagel/","title":"VERISEC-register: vericiguat halveert hartfalen-decompensaties bij HFrEF in dagelijkse Spaanse praktijk","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog","internist"],"tags":["acuut-hartfalen"],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag138","source_url":"https://doi.org/10.1093/eschf/xvag138","authors":["Alberto Esteban-Fernández","Beatriz Calvo-Bernal","Raquel López-Vilella","Gregorio de Lara","Laia C Belarte-Tornero","Moisés Barrantes-Castillo","Inés Gómez-Otero","Julio Nuñez-Villota","Carolina Robles-Gamboa","José López-Aguilera","Ana Torremocha-López","María Melendo-Viu","Clara Simón-Ramón","Paula Fluvià-Burgués","Francisco J Pastor-Pérez","Gonzalo Alonso-Salinas","José Manuel García-Pinilla","Antonia Pomares-Varó","Jara Gayán-Ordás","David González-Calle","Pablo Díez-Villanueva","Mario Galván-Ruiz","Carolina Ortiz-Cortés","Pedro Caravaca-Pérez","Cristina Goena-Vives","Julia Seller","Marta Jiménez-Blanco","Pau Codina","José María Vietiez","Laura Jordán-Martínez","Maria Thiscal López-Lluva","Elisabet Mena-Sebastià","Pedro Pájaro","Alejandro Recio-Mayoral"],"significance":7,"published":"2026-06-21","source_date":"2026-05-13","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/hfref-hartfalen-met-verminderde-ejectie/","https://hartvaat.nl/kennis/hartfalen/bnp-en-nt-probnp/"],"congress":"","summary_en":"Prospective multicenter registry (VERISEC) of 835 consecutive patients with HFrEF after recent decompensation initiating vericiguat at 41 Spanish centres (mean age 71.3 years, 78.9% male). Baseline therapy was highly optimised: 91.5% SGLT2i, 90.7% beta-blockers, 85.4% RAAS inhibitors, 79.8% MRAs; quadruple therapy was 61.7-63.0% throughout follow-up. At 1 year, NT-proBNP fell from 3,532 to 2,292 pg/mL (p<0.001), LVEF rose from 30.3% to 35.4% (p<0.001), and NYHA class improved. HF decompensations requiring IV diuretics halved (1.34 → 0.65/year); non-HF cardiovascular hospitalisations fell from 0.98 to 0.39/year. Vericiguat was discontinued in 13.4%, mostly for symptomatic hypotension (49.4%); higher baseline NT-proBNP predicted discontinuation (OR 1.06 per 1,000 pg/mL). The real-world data confirm clinical utility and safety of vericiguat on top of quadruple therapy.","created":"2026-07-03T10:33:05Z","updated":"2026-07-03T18:39:36Z","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":"Prospectief multicenter register (VERISEC) van 835 opeenvolgende patiënten met HFrEF na recente decompensatie, gestart met vericiguat in 41 Spaanse centra (gemiddelde leeftijd 71,3 jaar, 78,9% mannen). Baseline-medicatie was sterk geoptimaliseerd: 91,5% SGLT2i, 90,7% bètablokker, 85,4% RAAS-remmer, 79,8% MRA; kwadrupletherapie bleef 61,7-63,0% gedurende follow-up. Na 1 jaar daalde NT-proBNP van 3.532 naar 2.292 pg/mL (p<0,001), LVEF steeg van 30,3% naar 35,4% (p<0,001) en NYHA-klasse verbeterde. HF-decompensaties met IV-diuretica halveerden (1,34 → 0,65/jaar), niet-HF cardiovasculaire opnames daalden van 0,98 naar 0,39/jaar. Vericiguat werd in 13,4% gestaakt, vooral wegens symptomatische hypotensie (49,4%); hogere baseline NT-proBNP voorspelde staking (OR 1,06 per 1.000 pg/mL). De real-world data bevestigen klinisch nut en veiligheid van vericiguat bovenop kwadrupletherapie.","abstract_original":"AIMS: To evaluate the effectiveness and safety of vericiguat in patients with heart failure and reduced ejection fraction (HFrEF) following recent decompensation in routine clinical practice in Spain. METHODS: VERISEC is a prospective, multicenter registry of 835 consecutive patients initiating vericiguat at 41 centers in Spain. Functional class, biochemical markers, ventricular function, and clinical events were analyzed during 1-year follow-up. RESULTS: Patients (age 71.3 years [SD: 11.2], 78.9% male) received highly optimized baseline therapy: 91.5% SGLT2i, 90.7% beta-blockers, 85.4% RAASi, and 79.8% MRAs. Quadruple therapy remained stable (61.7% baseline to 63.0% at 12 months; p=0.526). At 1-year follow-up, significant improvements were observed. NT-proBNP decreased from 3532.0 (IQR: 1689.3-6974.5) to 2291.5 pg/mL (IQR: 1063.0-5076.3; p<0.001) and LVEF increased from 30.3% (SD: 7.6) to 35.4% (SD: 11.1; p<0.001). NYHA class improved, with class II patients increasing from 55.6% to 62.2% (p<0.001). Mean HF decompensations requiring intravenous diuretics decreased from 1.34 (SD: 1.1) in the preceding year to 0.65 (SD: 1.3) during follow-up. Non-HF cardiovascular hospitalizations decreased from 0.98 (SD: 1.4) to 0.39 (SD: 1.0). Vericiguat was discontinued in 13.4% of patients, primarily due to symptomatic hypotension (49.4%). Higher baseline NT-proBNP (per 1000-pg/mL increase) independently predicted discontinuation (OR: 1.06; 95% CI: 1.03-1.08; p<0.001). CONCLUSIONS: Vericiguat added to optimized quadruple therapy was associated with reverse remodeling, reduced NT-proBNP, improved functional class, and a numerical reduction in HF-related events in real-world HFrEF patients. These findings confirm the clinical utility and safety of vericiguat in routine practice."}