Safety and tolerability of rapid vericiguat initiation and titration alongside GDMT optimization in HFrEF: a prospective cohort study.
- 1Department of the Cardiovascular Center, The First Hospital of Jilin University, C71 Xinmin Street, Jilin Province, 130021, Changchun City, P.R. China.
- 2Department of the Cardiovascular Center, The First Hospital of Jilin University, C71 Xinmin Street, Jilin Province, 130021, Changchun City, P.R. China. [email protected].
Abstract
Background
Heart failure with reduced ejection fraction (HFrEF) remains challenging to manage, particularly in Asian populations. Although vericiguat may complement guideline-directed medical therapy (GDMT), the safety and tolerability of rapid initiation and titration in Chinese patients with HFrEF require further evaluation.Methods
This single-center, prospective, single-arm, self-controlled cohort study included 140 patients who received at least 1 dose of vericiguat 5 mg and constituted the treated population; 133 had evaluable 14-day titration and short-term safety data. Patients were monitored for dose-titration success, blood pressure, renal function, electrolytes, hepatic function, hemoglobin, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) over 14 days. Echocardiography was performed at 12 and 20 weeks.Results
The mean age was 61.5 ± 14.2 years, and baseline left ventricular ejection fraction (LVEF) was 32.87 ± 8.51%. On a treated-population basis, 131 of 140 patients (93.6%) achieved the target vericiguat dose of 10 mg by day 14; among patients with evaluable titration data, 131 of 133 (98.5%) achieved target-dose uptitration. Median NT-proBNP decreased by 44.0% from baseline to day 14 (p < 0.001), without clinically notable blood pressure changes on the day after vericiguat initiation. At 20 weeks, LVEF increased by 8.26% (p < 0.001), accompanied by reductions in left ventricular diastolic diameter and left atrial diameter. No significant renal, hepatic, or electrolyte safety signals were observed.Conclusions
Rapid initiation of vericiguat 5 mg alongside GDMT optimization showed acceptable short-term safety and tolerability in Chinese patients with HFrEF. These findings support further randomized controlled trials to clarify the independent contribution of vericiguat to cardiac remodeling.
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BibTeX
@article{gao2026safety,
title = {{Safety and tolerability of rapid vericiguat initiation and titration alongside GDMT optimization in HFrEF: a prospective cohort study.}},
author = {Lu Gao and Botao Shen and Haoxuan Chu and Zhen Guo and Yushi Wang},
journal = {Journal of cardiothoracic surgery},
year = {2026},
month = jul,
doi = {10.1186/s13019-026-04518-7},
url = {https://europepmc.org/article/MED/42928201},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Safety and tolerability of rapid vericiguat initiation and titration alongside GDMT optimization in HFrEF: a prospective cohort study.
AU - Lu Gao
AU - Botao Shen
AU - Haoxuan Chu
AU - Zhen Guo
AU - Yushi Wang
PY - 2026
DA - 2026/07/29
JO - Journal of cardiothoracic surgery
DO - 10.1186/s13019-026-04518-7
UR - https://europepmc.org/article/MED/42928201
AB - Background Heart failure with reduced ejection fraction (HFrEF) remains challenging to manage, particularly in Asian populations. Although vericiguat may complement guideline-directed medical therapy (GDMT), the safety and tolerability of rapid initiation and titration in Chinese patients with HFrEF require further evaluation.Methods This single-center, prospective, single-arm, self-controlled cohort study included 140 patients who received at least 1 dose of vericiguat 5 mg and constituted the treated population; 133 had evaluable 14-day titration and short-term safety data. Patients were monitored for dose-titration success, blood pressure, renal function, electrolytes, hepatic function, hemoglobin, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) over 14 days. Echocardiography was performed at 12 and 20 weeks.Results The mean age was 61.5 ± 14.2 years, and baseline left ventricular ejection fraction (LVEF) was 32.87 ± 8.51%. On a treated-population basis, 131 of 140 patients (93.6%) achieved the target vericiguat dose of 10 mg by day 14; among patients with evaluable titration data, 131 of 133 (98.5%) achieved target-dose uptitration. Median NT-proBNP decreased by 44.0% from baseline to day 14 (p < 0.001), without clinically notable blood pressure changes on the day after vericiguat initiation. At 20 weeks, LVEF increased by 8.26% (p < 0.001), accompanied by reductions in left ventricular diastolic diameter and left atrial diameter. No significant renal, hepatic, or electrolyte safety signals were observed.Conclusions Rapid initiation of vericiguat 5 mg alongside GDMT optimization showed acceptable short-term safety and tolerability in Chinese patients with HFrEF. These findings support further randomized controlled trials to clarify the independent contribution of vericiguat to cardiac remodeling.
SN - 1749-8090
ER -