Vericiguat – possibly next weapon to overcome heart failure. Review of latest literature

Introduction Heart failure (HF) is a common clinical syndrome characterized by symptoms such as breathlessness and fatigue, affecting 1-2% of adults in developed countries. Standard treatment for heart failure with reduced ejection fraction (HFrEF) includes a "new quadruple" therapy comprising ARNI/ACE-I, beta-blockers, MRAs, and SGLT2i. However, a subset of patients remains inadequately managed, highlighting the need for new therapies like vericiguat. Vericiguat, an oral soluble guanylate cyclase (sGC) stimulator approved by the FDA in January 2021, shows promise for patients with heart failure with reduced ejection fraction (HFrEF). This review highlights vericiguat's pharmacodynamics, including its mechanism that enhances nitric oxide effects and promotes vasodilation, thereby improving hemodynamic status. Materials and Methods This review synthesizes recent literature on vericiguat sourced from PubMed and Cochrane databases, including studies published in English between 2023 and 2024. Eight relevant publications were selected based on strict inclusion criteria. Results Reviewed studies demonstrate that vericiguat significantly reduces NT-proBNP levels and lowers the risk of composite cardiovascular death or HF hospitalization. Notably, vericiguat showed efficacy in specific subgroups, including patients with chronic kidney disease and those in NYHA class III/IV. Conclusion Vericiguat is a promising candidate for inclusion in the "new quadruple" therapy for HF, particularly for patients with severe symptoms or chronic kidney disease. Further research is essential to clarify its benefits in stable HF patients and its comparative efficacy alongside current guideline-directed medical therapy.