{"id":"e62a4fd927c7","type":"article","url":"https://hartvaat.nl/2026/05/13/verisec-vericiguat-in-de-praktijk-halveert-hartfalen-decompensaties-bij-hfref-sp/","title":"VERISEC: vericiguat in de praktijk halveert hartfalen-decompensaties bij HFrEF — Spaanse 1-jaars registry van 835 patiënten","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","huisarts","internist"],"tags":["acuut-hartfalen","heart-failure-2026"],"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","VERISEC Investigators"],"significance":8,"published":"2026-05-15","source_date":"2026-05-13","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/hfref-hartfalen-met-verminderde-ejectie/","https://hartvaat.nl/kennis/hartfalen/vericiguat-bij-hartfalen/"],"congress":"heart-failure-2026","summary_en":"VERISEC (n=835, 41 Spanish centres) confirms vericiguat's real-world benefit in HFrEF after recent decompensation. Over 12 months on top of >90% SGLT2i / >85% RAASi / ~80% MRA / 91% beta-blocker background, NT-proBNP fell from 3,532 to 2,292 pg/mL (p<0.001), LVEF rose from 30.3% to 35.4%, NYHA class improved, and HF decompensations requiring IV diuretics halved (1.34 → 0.65 per year). 13.4% discontinued, mostly for symptomatic hypotension; higher baseline NT-proBNP predicted discontinuation.","created":"2026-07-03T10:32:56Z","updated":"2026-07-03T18:39:33Z","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":"VERISEC — prospectief multicentrisch register van 835 opeenvolgende HFrEF-patiënten in 41 Spaanse centra die vericiguat startten na recente decompensatie, 12 maanden gevolgd. Patiënten waren 71 jaar (SD 11), 79% man, en stonden op zwaar geoptimaliseerde achtergrondtherapie: 92% SGLT2-remmer, 91% bètablokker, 85% RAAS-remmer en 80% MRA. Na 12 maanden: NT-proBNP daalde van 3.532 naar 2.292 pg/mL (p<0,001), LVEF steeg van 30,3% naar 35,4% (p<0,001), NYHA-klasse verbeterde substantieel, hartfalen-decompensaties die intraveneuze diuretica vereisten daalden van 1,34/jaar naar 0,65/jaar — een halvering. Niet-HF cardiovasculaire opnames daalden van 0,98 naar 0,39/jaar. Vericiguat werd gestopt bij 13,4%, meestal door symptomatische hypotensie. Hogere baseline NT-proBNP voorspelde discontinuering. Conclusie: in de echte praktijk bevestigt en versterkt VERISEC de VICTORIA-trial. Vericiguat past in de Nederlandse vierpijler-plus benadering bij HFrEF-patiënten met recente decompensatie en persisterende verhoogde NT-proBNP, met hypotensie als belangrijkste reden voor stoppen.","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 3,532 to 2,292 pg/mL (p<0.001) and LVEF increased from 30.3% to 35.4% (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/year pre-treatment to 0.65/year during follow-up (≈51% reduction). Non-HF cardiovascular hospitalizations decreased from 0.98 to 0.39 per year. Vericiguat was discontinued in 13.4% of patients, primarily due to symptomatic hypotension (49.4% of discontinuations). Higher baseline NT-proBNP independently predicted discontinuation (OR 1.06 per 1,000-pg/mL increase; 95% CI 1.03–1.08; p<0.001). Conclusions: In a large real-world Spanish cohort initiating vericiguat after HF decompensation, treatment was associated with improved biomarkers, LV function and functional class, and a halving of HF decompensations — confirming and extending the VICTORIA trial in routine practice."}