Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2023; 11(35): 8330-8342
Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8330
Vericiguat treatment of heart failure: A systematic review and meta-analysis
Heng Yang, Chao Luo, Wan-Qi Lan, Yan-Hua Tang
Heng Yang, Chao Luo, Wan-Qi Lan, Yan-Hua Tang, Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330008, Jiangxi Province, China
Co-first authors: Heng Yang and Chao Luo.
Author contributions: Yang H, Luo C, and Lan WQ contributed to data collection and analysis; Yang H and Luo C drafted the manuscript; Tang YH reviewed and revised the manuscript. All authors read and approved the final version of this manuscript.
Supported by Key Research and Development projects in Jiangxi Province, No. 20223BBG71010; and National Natural Science Foundation of China, No. 81960058.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Hua Tang, PhD, Professor, Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Donghu District, Nanchang 330008, Jiangxi Province, China. tyh6565@163.com
Received: September 13, 2023
Peer-review started: September 13, 2023
First decision: November 1, 2023
Revised: November 12, 2023
Accepted: November 28, 2023
Article in press: November 28, 2023
Published online: December 16, 2023
Processing time: 91 Days and 11.5 Hours
Abstract
BACKGROUND

Heart failure (HF), an end-stage manifestation of various cardiac diseases, poses an enormous economic and health burden on society. Vericiguat may be an effective drug in the treatment of HF.

AIM

To explore by meta-analysis the efficacy and safety of Vericiguat in treating chronic heart failure.

METHODS

Databases, including PubMed, EMBASE, Web of Science, and Cochrane Library, were searched to collect all published randomized controlled trials (RCTs) on Vericiguat treatment of chronic heart failure from the earliest electronic records to those published in March 2023. Two investigators independently screened the literature according to inclusion and exclusion criteria, evaluated the quality of the studies, and extracted valid data before conducting a meta-analysis using RevMan5.4.

RESULTS

Four RCTs with 5919 patients were included, and the meta-analysis showed that treatment with 10 mg Vericiguat reduced the incidence of the primary endpoint (a composite of cardiovascular mortality and first heart-failure-related hospitalization) in patients with chronic heart failure compared to placebo [relative risk (RR) = 0.91, 95% confidence interval (CI): 0.85–0.98, P = 0.01], and reduced the incidence of heart-failure-related hospitalization (RR = 0.92, 95%CI: 0.84–1.00, P = 0.05). However, for the incidence of cardiovascular and all-cause death, there were no significant differences between the Vericiguat and placebo groups. In addition, the two groups did not show significant differences in blood pressure, heart rate, and Kansas Cardiomyopathy Questionnaire physical limitation score. In terms of safety, 10 mg Vericiguat did not increase the risk of adverse effects in patients with chronic heart failure. Vericiguat may increase the risk of symptomatic hypotension (RR = 1.17, 95%CI: 0.98–1.39, P = 0.08) and syncope (RR = 1.18, 95%CI: 0.90–1.55, P = 0.24), but not significantly.

CONCLUSION

Vericiguat (10 mg) was more effective than placebo in treating patients with chronic heart failure and had a better safety profile.

Keywords: Vericiguat; Chronic heart failure; Randomized controlled trials; Meta analysis

Core Tip: Heart failure is a major public health problem and a leading cause of mortality worldwide. Vericiguat may be a novel drug effective in slowing the progression of heart failure. We performed a meta-analysis and found that commonly used doses of Vericiguat resulted in a significant benefit in heart failure patients with reduced ejection fraction. Further studies are needed to confirm the long-term efficacy and safety of Vericiguat in heart failure.