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Not yet recruitingNCT07697833VERICIGUATUpdated Jul 13, 2026

Comparing the Efficacy and Safety of Vericiguat With Standard Medical Treatment in Heart Failure Patients

A Phase 4 interventional study of Vericiguat tablet and Placebo in Heart Failure With Reduced Ejection Fraction (HFrEF), sponsored by National Institute of Cardiovascular Diseases, Pakistan. Not yet recruiting. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-07-13.

Sponsored by National Institute of Cardiovascular Diseases, Pakistan · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
500
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

To compare the effectiveness and safety of Vericiguat with Standard Medical Treatment in Patients with Heart Failure and Reduced Ejection Fraction

Read the detailed description

Heart failure with reduced ejection fraction (HFrEF) remains a major cause of morbidity, mortality, and healthcare utilization despite advances in guideline-directed medical therapy. Patients who experience worsening heart failure events, including hospitalization or the need for urgent outpatient treatment, remain at increased risk of recurrent cardiovascular events and represent a high-risk population requiring additional therapeutic strategies.

The nitric oxide-soluble guanylate cyclase (NO-sGC)-cyclic guanosine monophosphate (cGMP) pathway plays an important role in maintaining cardiovascular function. In heart failure, endothelial dysfunction and reduced nitric oxide bioavailability may impair this pathway, contributing to vascular dysfunction, myocardial remodeling, and disease progression.

Vericiguat is an oral soluble guanylate cyclase stimulator that enhances cGMP production by directly stimulating soluble guanylate cyclase and increasing its sensitivity to endogenous nitric oxide. This mechanism provides a novel therapeutic approach that differs from conventional heart failure treatments targeting neurohormonal pathways.

Previous clinical evidence, including the VICTORIA trial, demonstrated that vericiguat reduced the risk of cardiovascular death or first hospitalization for heart failure among patients with chronic heart failure and recent worsening heart failure events. However, further evaluation of its effectiveness and safety in specific clinical settings and populations remains important.

This randomized, placebo-controlled, double-blind clinical trial will evaluate the effectiveness and safety of vericiguat in patients with heart failure with reduced ejection fraction receiving standard medical therapy. The study aims to determine whether the addition of vericiguat provides further clinical benefit compared with standard therapy alone in this high-risk patient population.

02

Conditions studied

  • Heart Failure With Reduced Ejection Fraction (HFrEF)

Keywords

  • Vericiguat
  • Heart Failure
  • Reduced Ejection Fraction (HFrEF)
  • Chronic Heart Failure
  • Cardiovascular Diseases
  • Randomized Controlled Trial
  • Double Blind
  • Placebo-Controlled
  • Soluble Guanylate Cyclase Stimulator
  • NT-proBNP
03

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Age >18 years of any gender
  2. Chronic heart failure (New York Heart Association [NYHA] functional class II, III, or IV), a reduced left ventricular ejection fraction of less than 45% within 12 months before randomization
  3. Elevated natriuretic peptide level: (For patients in sinus rhythm, the criteria include a plasma B-type natriuretic peptide (BNP) level of at least 300 pg per milliliter or an NT-proBNP level of at least 1000 pg per milliliter. For patients in atrial fibrillation, the criteria included a BNP level of at least 500 pg per milliliter or an NT-proBNP level of at least 1600 pg per milliliter).
  4. Evidence of worsening heart failure.
  5. The percentage of enrolled patients with an estimated glomerular filtration rate of 15 to 30 ml per minute per 1.73 m2 of body-surface area was capped at 15%.
  6. Patients on guideline-based medical therapy 3 months
  7. Written and informed consent.

Exclusion criteria

Exclusion Criteria:

  1. Systolic blood pressure of less than 100 mm Hg.
  2. Concurrent or anticipated use of long-acting nitrates.
  3. Use of intravenous inotropes or implantable left ventricular assist devices.
  4. Not on standard of care medical treatment for heart failure.
  5. Unwillingness to give consent
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
500 participants (estimated)

Study arms

  • Experimental
    Treatment

    Vericiguat 10 mg (titrated from 2.5 mg, to 5 mg, and to 10 mg), on a background of standard of care

    Drug: Vericiguat tablet

  • Placebo comparator
    Placebo

    Standard of care medications with placebo.

    Drug: Placebo

Interventions

  • DrugVericiguat tablet

    Vericiguat 10 mg (titrated from 2.5 mg, to 5 mg, and to 10 mg), on a background of standard of care

    Also known as: VERIZOT

  • DrugPlacebo

    Participants will receive a matching placebo tablet. The placebo will follow the same dosing schedule as the study drug (2.5 mg, 5 mg, and 10 mg) to maintain blinding.

    Also known as: VERIZOT

05

What researchers measure

Primary outcomes

  1. Quality of life using Kansas City Cardiomyopathy Questionnaire (KCCQ-12)

    The Kansas City Cardiomyopathy Questionnaire (KCCQ-12) is a validated, patient-reported instrument that assesses health status, including symptoms, physical limitations, social limitations, and quality of life in patients with heart failure. The Overall Summary Score ranges from 0 to 100, with higher scores indicating better health status. The primary endpoint is the change in the KCCQ-12 Overall Summary Score from baseline to Month 6.

    Time frame: Baseline to Month 6

Secondary outcomes

  1. First Hospitalization for Heart Failure

    Time to first hospitalization for worsening heart failure during the study follow-up.

    Time frame: From enrollment to Month 6

06

Study locations

No study locations are listed for this record.

07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07697833
Lead sponsor
National Institute of Cardiovascular Diseases, Pakistan
Collaborators
Horizon Pharmaceuticals
Responsible party
Sponsor
First posted
Jul 13, 2026
Start date
Jul 15, 2026 (estimated)
Primary completion
May 15, 2027 (estimated)
Completion
Jul 31, 2027 (estimated)
Last update
Jul 13, 2026

Study contacts

Ghazala Irfan, FCPS
Contact
ghazala.irfan@gmail.com
+92 3002167206
Reema Qayoom, FCPS
Contact
dr.reemaqayoom@gmail.com
+92 3333864264
Ghazala Irfan, FCPS
principal investigator · National Institute of Cardiovascular Diseases Karachi, Pakistan

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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