Vericiguat for HFrEF

Vericiguat is an oral soluble guanylate cyclase stimulator. It increases intracellular cyclic guanosine monophosphate by directly stimulating soluble guanylate cyclase and increasing the sensitivity of soluble guanylate cyclase to endogenous nitric oxide; this leads to vasodilation, inhibition of smooth muscle proliferation as well as reduced inflammation and platelet aggregationLang, 2020.

When vericiguat is used in combination with a renin-angiotensin system inhibitor, beta blocker and a mineralocorticoid receptor antagonist in patients with persistent HFrEF and recent worsening heart failure, it reduces cardiovascular mortality and heart failure hospitalisationArmstrong, 2020. However, patients with very advanced heart failure are less likely to benefitEzekowitz, 2020. Vericiguat can be considered for use by a specialist for patients with persistent HFrEF who have recently been hospitalised for heart failureSindone, 2022. Use: