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Hofmeyer M, Haas G, Kransdorf E, Ewald G, Morris A, Owens A, Lowes B, Stoller D, Tang W, Garg S, Trachtenberg B, Shah P, Pamboukian S, Sweitzer N, Wheeler M, Wilcox J, Katz S, Pan S, Jimenez J, Smart F, Wang J, Gottlieb S, Judge D, Moore C, Huggins G, Jordan E, Kinnamon D, Ni H, Hershberger R. Genetic Signature of Dilated Cardiomyopathy Severity: The DCM Precision Medicine Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Meyer J, Sweitzer N, Aravot D, Milano C, Barac Y. Heart Transplant Survival and the Use of Donors with Intracranial Bleeding: Unos Registry Propensity Matched Analysis. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Butler J, Stebbins A, Melenovsky V, Sweitzer N, Cowie M, Stehlik J, Ezekowitz J, Hernandez A, Lam C, Nkulikiyinka R, O'Connor C, Pieske B, Ponikowski P, Voors A, Armstrong P. Vericiguat and health status outcomes in heart failure with reduced ejection fraction: insights from the VICTORIA trial. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In the VICTORIA trial, vericiguat compared with placebo reduced the risk of the primary endpoint of cardiovascular death (CVD) or hospitalization for heart failure (HFH) among 5050 patients with worsening HF with reduced ejection fraction (HFrEF).
Purpose
We evaluated whether the efficacy of vericiguat on clinical outcomes varied according to participants' baseline health status, as assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ)-23, and how vericiguat affected health status post-randomization.
Methods
KCCQ-23 was completed at randomization and at 4, 16, and 32 weeks. Patients were grouped based on tertiles of baseline KCCQ total symptom score (TSS; <55.2, 55.2–79.2, and >79.2), clinical summary score (CSS; <52.1, 52.1–76.0, and >76.2) and overall summary score (OSS; <48.5, 48.5–70.8, and >70.8) across tertiles 1–3, respectively. Cox proportional hazard models were performed for the tertiles to evaluate the effects of vericiguat on the primary outcomes.
Results
Overall 4741, 4664, and 4470 participants had KCCQ-TSS (median 68.8 [interquartile range 47.9, 85.4]), KCCQ-CSS (65.6 [45.8, 81.8]) and KCCQ-OSS (59.9 [42.0, 77.1]) available at baseline. Vericiguat reduced CVD or HFH risk across baseline KCCQ-TSS (P=0.21), KCCQ-CSS (P=0.13) and KCCQ-OSS (P=0.65) tertiles (Table). The effect of vericiguat on HFH alone was also not modified by baseline KCCQ-TSS, CSS and OSS (all P>0.05) scores. At 4 weeks after randomization, improvement in both vericiguat and placebo arms was seen in KCCQ-TSS (vericiguat 6.3 vs. placebo 6.3; P=0.85), KCCQ-CSS (vericiguat: 5.7 vs. placebo 5.7, P=0.54), and KCCQ-OSS (vericiguat 6.3 vs. placebo 5.7, P=0.36). Similar results were seen at weeks 16 and 32.
Conclusion
Vericiguat reduced the risk of the composite outcome of CVD or HFH as well as HFH alone across the range of baseline health status. Addition of vericiguat to best standard of care did not significantly improve health status compared with standard of care alone in HF patients with a recent worsening event. The early improvement in KCCQ seen in both randomized groups underscore the need to assess trajectory of health status changes in the spectrum of patients with HFrEF.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Merck & Co., Inc. and Bayer
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Affiliation(s)
- J Butler
- The University of Mississippi Medical Center, Jackson, United States of America
| | - A Stebbins
- Duke Clinical Research Institute, Durham, United States of America
| | - V Melenovsky
- Institute for Clinical and Experimental Medicine-IKEM, Prague, Czechia
| | - N Sweitzer
- University of Arizona, Sarver Heart Center, Tucson, United States of America
| | - M.R Cowie
- Imperial College London, London, United Kingdom
| | - J Stehlik
- University of Utah, Salt Lake City, United States of America
| | | | - A.F Hernandez
- Duke Clinical Research Institute, Durham, United States of America
| | - C.S.P Lam
- National Heart Centre Singapore, Duke-National University of Singapore, Singapore, Singapore
| | | | - C.M O'Connor
- Inova Heart and Vascular Institute, Falls Church, United States of America
| | - B Pieske
- Charite - Campus Virchow-Klinikum (CVK), Berlin, Germany
| | | | - A.A Voors
- University Medical Center Groningen, Groningen, Netherlands (The)
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Breathett K, Yee E, Pool N, Hebdon M, Crist J, Yee R, Knapp S, Solola S, Luy L, Herrera‐Theut K, Zabala L, Stone J, McEwen M, Calhoun E, Sweitzer N. Sex and Race Biases in Allocation of Advanced Heart Failure Therapies. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
| | - E. Yee
- University of Arizona Tucson AZ United States
| | - N. Pool
- University of Arizona Tucson AZ United States
| | - M. Hebdon
- University of Arizona Tucson AZ United States
| | - J. Crist
- University of Arizona Tucson AZ United States
| | - R. Yee
- University of Arizona Tucson AZ United States
| | - S. Knapp
- University of Arizona Tucson AZ United States
| | - S. Solola
- University of Arizona Tucson AZ United States
| | - L. Luy
- University of Rochester Rochester NY United States
| | | | - L. Zabala
- University of Arizona Tucson AZ United States
| | - J. Stone
- University of Arizona Tucson AZ United States
| | - M. McEwen
- University of Arizona Tucson AZ United States
| | - E. Calhoun
- University of Arizona Tucson AZ United States
| | - N. Sweitzer
- University of Arizona Tucson AZ United States
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Breathett K, Maffett S, Foraker R, Sturdivant R, Moon K, Hasan A, Franco V, Smith S, Lampert B, Emani S, Haas G, Kahwash R, Hershberger R, Binkley P, Helmkamp L, Colborn K, Peterson P, Sweitzer N, Abraham W. Pilot Randomized Controlled Trial to Reduce Readmission for Heart Failure Using Novel Tablet and Nurse Practitioner Education. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Biering-Sorensen T, Shah S, Anand I, Sweitzer N, Claggett B, Pitt B, Pfeffer M, Solomon S, Shah A. P6178Prognostic importance of pulmonary pressure in heart failure with preserved ejection fraction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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