A Study of Vericiguat in Participants with Heart Failure with Reduced Ejection Fraction (HFrEF)

Heart failure with reduced ejection fraction (HFrEF) is a major public health challenge, especially for patients with recent decompensation despite optimal medical therapy. Vericiguat, a novel oral soluble guanylate cyclase stimulator, enhances the cyclic GMP pathway to restore cardiovascular homeostasis. Objective: To evaluate the efficacy and safety of vericiguat versus standard care in patients with heart failure with reduced ejection fraction (HFrEF). Methods: This case-control study was conducted at North East Medical College, Bangladesh, from 2022 to 2023. It enrolled 50 HFrEF patients receiving vericiguat (2.5–10 mg daily) and 50 controls on standard care, randomly selected from the coronary care unit. Eligibility criteria included NYHA class II–IV, EF <45%, elevated natriuretic peptides, and hemodynamic stability. Follow-up lasted six months. Data were analyzed using SPSS version 23.0, applying chi-square and t-tests for group comparisons. Results: Over six months, vericiguat significantly reduced cardiovascular death (20% vs. 30%, P=0.02), heart failure hospitalization (24% vs. 32%, P=0.02), and all-cause mortality (26% vs. 36%, P=0.02) compared with controls. The safety profile was similar, with no significant between-group differences in symptomatic hypotension (10% vs. 16%, P=0.12), syncope (4% vs. 8%, P=0.12), or anemia (4% vs. 2%, P=0.13). Conclusion: Vericiguat significantly reduced cardiovascular death and heart failure hospitalization in high-risk HFrEF patients over six months, while demonstrating a manageable safety profile. These findings support the clinical utility of adding vericiguat to standard guideline-directed medical therapy.