Effectiveness of vericiguat in heart failure across ejection fraction phenotypes: a comprehensive meta-analytic trial sequential analysis and meta-regression analysis
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Le résumé fourni par la source
Background: Heart failure (HF) remains a global health challenge, with distinct phenotypes – heart failure with reduced ejection fraction (HFrEF ≤40%) and heart failure with preserved ejection fraction (HFpEF ≥50%) – requiring tailored therapies. Vericiguat, a soluble guanylate cyclase stimulator, targets the nitric oxide -soluble guanylate cyclase-cyclic guanosine monophosphate pathway to reduce cardiac stress, showing promise in HFrEF but with unclear efficacy in HFpEF. This meta-analysis evaluates Vericiguat’s effectiveness across HF phenotypes using trial sequential analysis (TSA) and meta-regression. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we included eight randomized controlled trials (17,381 patients) comparing Vericiguat to control in HFrEF and HFpEF patients. Outcomes assessed were hospitalization for HF, all-cause mortality, cardiovascular mortality, and the composite endpoint (cardiovascular death or first hospitalization). Random-effects models calculated pooled risk ratio (RR). TSA controlled for type I/II errors, and meta-regression explored covariates (age, sex, NT-proBNP, HF subgroup). Sensitivity analyses assessed robustness. Results: Vericiguat reduced hospitalization for HF (RR: 0.90, 95% confidence interval [CI]: 0.82–0.98, P = 0.0201) and the composite endpoint (RR: 0.88, 95% CI: 0.78–0.99, P = 0.035), but TSA indicated inconclusive evidence (required information sizes: 29,929 and 48,016 patients, respectively). No significant effect was observed for all-cause mortality (RR: 0.98, 95% CI: 0.68–1.40, P = 0.904) or cardiovascular mortality (RR: 0.91, 95% CI: 0.64–1.30, P = 0.6091). Heterogeneity was minimal ( I 2 = 0–17%). Meta-regression showed no significant covariate effects, though HFrEF trended toward benefit ( P = 0.1329). Sensitivity analysis identified VITALITY-HFpEF as an influential outlier. Conclusions: Vericiguat modestly reduces hospitalization and composite outcomes in HF, particularly HFrEF, but lacks mortality benefits. Larger, phenotype-specific trials are needed to confirm efficacy, especially in HFpEF, to refine Vericiguat’s role in HF management.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Effectiveness of vericiguat in heart failure across ejection fraction phenotypes: a comprehensive meta-analytic trial sequential analysis and meta-regression analysis
- Date Crossref
- 03/06/2026
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Dhaka Medical College and Hospital Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Shaheed Suhrawardy Medical College Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Chattagram Maa-O-Shishu Hospital Medical College pays non établi dans la noticeUniversité ou école supérieure
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University of Kerbala pays non établi dans la noticeUniversité ou école supérieure
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University of Warith Al-Anbiyaa pays non établi dans la noticeUniversité ou école supérieure
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Jalalabad Ragib Rabeya Medical College Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Chattogram Medical College and Hospital Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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College of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Manikganj Medical College and Hospital Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
Department of Medicine — Dhaka Medical College and Hospital, Department of Medicine — Shaheed Suhrawardy Medical College et Chattagram Maa-O-Shishu Hospital Medical College, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.