Practical Patient Care Considerations With Use of Vericiguat After Worsening Heart Failure Events

Vericiguat is a soluble guanylate cyclase stimulator approved by multiple global regulatory bodies and recommended in recently updated clinical practice guidelines to reduce morbidity and mortality in patients with worsening chronic heart failure (HF) with reduced ejection frac-tion (HFrEF). Despite the growing armaments of evidence-based medical therapy for HFrEF that have demonstrated clinical outcome benefits, there is a need to address residual risk following worsening HF events. When considering therapies aimed to mitigate postevent cardio-vascular risk, potential barriers preventing the prescription of vericiguat in eligible patients may include providers' lack of familiarity with it, clinical inertia, limited knowledge about monitoring response to therapy, and concerns about potential adverse effects as well as inte-gration of its routine use during an era of in-person and telehealth hybrid ambulatory care. This review provides an overview of vericiguat therapy and proposes an evidence-based and practical guidance strategy toward implementing its use in various clinical settings. This review additionally summarizes patient counseling points for its initiation and maintenance. (J Cardiac Fail 2023;29:389-402)

Automated summary

Vericiguat is a recommended therapy for reducing morbidity and mortality in patients with worsening chronic heart failure. However, there are potential barriers to its prescription, such as lack of familiarity among providers and concerns about adverse effects. This review provides an overview of vericiguat therapy, proposes a guidance strategy, and summarizes patient counseling points.