ArticleCardiology and therapy2026
Study Design and Baseline Characteristics of the VERINA Study: Phase IV Evidence of Vericiguat for Worsening Heart Failure Management.
Article in Cardiology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPatients with heart failure with reduced ejection fraction (HFrEF) experience higher rates of in-hospital and all-cause mortality. On the basis of the VERINA trial, vericiguat is indicated for patients who have had a worsening heart failure (WHF) event despite optimal heart failure (HF) therapy, or for those with tolerability concerns.
methodsThis multicenter, prospective, single-arm, non-randomized, real-world, descriptive study assessed the efficacy and safety of vericiguat in Indian patients aged ≥18 years with chronic HFrEF who were vericiguat-naïve and started treatment as per the local label. This analysis is based on interim data and the final results may differ. The main endpoint was a composite of cardiovascular (CV) death or first HF hospitalization. Secondary endpoints included each component of the primary outcome, all-cause death, and safety. Dose-titration parameters, including time to reach and duration at various dose levels, were also assessed.
resultsA total of 205 patients were enrolled (58.0 ± 13.27 years; 73.7% male; 34.1% aged ≥ 65 years, baseline N-terminal pro-B-type natriuretic peptide (NT-proBNP) 2490.1 pg/mL). Left ventricular ejection fraction (LVEF) < 30% was observed in 48.8% patients, 24.9% were in New York Heart Association (NYHA) class III. WHF events included recent HF hospitalization within < 7 days (10.7%) or 7 days-3 months (30.2%). Common background therapies included β-blockers (84.9%), mineralocorticoids receptor antagonist (MRAs) (80.5%), sodium-glucose cotransporter 2 (SGLT2) inhibitors (75.6%), and angiotensin receptor-neprilysin inhibitor (ARNI) (52.7%), with 66.3% receiving triple HF therapy. Vericiguat target dose (10 mg) was achieved by 91.1% of patients.
conclusionThis study enrolled high-risk patients with recent decompensation event consistent with the VICTORIA trial. The usage of standard of care (SoC) was as per current clinical practice in HF; VERINA enrolled 52.7% on ARNI compared to 14.5% in VICTORIA and 75.6% on SGLT2i compared to 2% in VICTORIA. Safety data did not reveal any new safety signals or adverse trends in the interim analysis.
trial registrationClinical Trials Registry of India (CTRI/2022/11/047636).
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