ArticleAmerican heart journal plus : cardiology research and practice2026
Initiation, titration, and safety of vericiguat for treatment of heart failure in United States clinical practice.
Article in American heart journal plus : cardiology research and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Study objective: To evaluate the following among new users of vericiguat: up-titration patterns, factors associated with up-titration, occurrence of hypotension/syncope, predictors of hypotension/syncope. Design: Retrospective cohort study (linked claims and electronic health record data). Setting: US clinical practice. Participants: 1361 new users of vericiguat. Interventions: N/A. Main outcome measures: Vericiguat starting dose, up-titration patterns and predictors, occurrence and predictors of hypotension/syncope, over a 3-month follow-up period. Results: Among 1361 new users of vericiguat, 770 (57%) initiated a starting dose of 2.5 mg/day, 330 (24%) initiated a dose of 5 mg/day, and 261 (19%) initiated a dose of 10 mg/day. Over 3-month follow-up, the 10 mg target dose was reached by 349 (26%) patients. Among these patients, the median time to reach the 10 mg dose was 60 days among 2.5 mg/day starters, and 41 days among 5 mg/day starters. Among the 2.5 mg starters, 68% had no up-titration. Among patients initiating either the 2.5 mg/day or 5 mg/day dose, a starting dose of 5 mg (vs. 2.5 mg) was the only significant predictor for reaching the 10 mg dose; adjusted hazard ratio 2.89 (95% CI: 1.86, 4.49, Conclusion: Vericiguat users initiated on the 5 mg/day dose were considerably more likely to reach the target dose of 10 mg/day vs. those started on the recommended 2.5 mg/day dose, without excess risk of hypotension or syncope.
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