In high-risk patients with HF, CAD confers worse outcomes
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In patients with HF from the VICTORIA trial, those with CAD had worse outcomes, according to a presentation at the American College of Cardiology Scientific Session.
Clara Saldarriaga, MD, associate professor at the University of Antioquia and cardiology program director for Universidad Pontificia Bolivariana (UPB) Clínica Cardio VID in Medellín, Colombia, and colleagues also found that the treatment effect of vericiguat (Verquvo, Merck) was similar in patients with or without CAD.
For this analysis, researchers characterized high-risk patients with worsening HF with reduced ejection fraction according to the presence of CAD in the VICTORIA trial. In addition, researchers evaluated whether a history of CAD had an effect on the study outcomes and the benefits provided by vericiguat.
The researchers analyzed 5,048 patients, of whom 58.3% had CAD.
According to the researchers, compared with patients with CAD, patients without CAD had a lower estimated glomerular filtration rate (53.5 vs. 63.3 mL/min/1.73 m2; P < .0001). In addition, compared with patients with no CAD, patients with CAD were older, more likely to be men, more likely to have diabetes, more likely to smoke and more likely to have chronic obstructive pulmonary disease.
The researchers found that compared with those without CAD, those with it were not treated as frequently with ACE inhibitors (71.1% vs. 76%; P < .0001) and mineralocorticoid receptor agonists (66.7% vs. 74.5%; P < .0001), whereas the use of sacubitril/valsartan (Entresto, Novartis) was similar between the groups (CAD, 14.3%; no CAD, 14.7%; P = .65).
In the analysis, utilization of implantable cardioverter defibrillators and cardiac resynchronization therapy occurred more in the CAD group (ICD, 33.5% vs. 21.1%; P = .0001; CRT, 16.3% vs. 12.8%; P = .0006).
At 2 years, compared with patients without CAD, patients with CAD had elevated risk for the primary endpoint of CV death or HF hospitalization (52.7% vs. 45%; adjusted HR = 1.23; 95% CI, 1.11-1.37; P < .001), according to the researchers.
According to the researchers, all-cause mortality was higher in the CAD group (34.8% vs. 27.2%; HR = 1.32; 95% CI, 1.15-1.53; P < .001) at 2 years.
In both patients with and without CAD, those assigned vericiguat had reduced risk for the primary endpoint compared with those assigned placebo, according to the researchers.
Reference:
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Saldarriaga C, et al. Ischemic Heart Disease: Clinical Science 2. Presented at: American College of Cardiology Scientific Session; May 15-17, 2021 (virtual meeting).
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