Ukwehluleka kwenhliziyo ngengxenye encishisiwe yokukhipha (i-HFrEF) kuwuhlobo olukhulu lokwehluleka kwenhliziyo, futhi Ucwaningo lwe-China HF lubonise ukuthi u-42% wokuhluleka kwenhliziyo e-China yi-HFrEF, nakuba amakilasi amaningana ajwayelekile okwelapha ezidakamizwa atholakalayo ku-HFrEF futhi anciphise ingozi. yokufa kanye nokulaliswa esibhedlela ngenxa yokwehluleka kwenhliziyo ngezinga elithile.Kodwa-ke, iziguli zisengozini enkulu yokwehluleka kwenhliziyo okuphindaphindayo izehlakalo eziya ziba zimbi, ukufa kusasele ku-25% futhi ukubikezelwa kusalokhu kubi.Ngakho-ke, sisenesidingo esiphuthumayo sama-ejenti okwelapha amasha ekwelapheni i-HFrEF, kanye ne-Vericiguat, isivuseleli se-soluble guanylate cyclase (sGC) inoveli, sacwaningwa ocwaningweni lwe-VICTORIA ukuze kuhlolwe ukuthi i-Vericiguat ingathuthukisa yini ukubikezelwa kweziguli ezine-HFrEF.Ucwaningo luyi-multicenter, randomized, parallel-group, i-placebo-controlled, blind-blind, event-driven, phase III imiphumela yomtholampilo.Iqhutshwa ngaphansi kwesikhungo se-VIGOR Centre eCanada ngokubambisana neDuke Clinical Research Institute, izikhungo ze-616 emazweni angu-42 nasezifundeni, kuhlanganise neYurophu, iJapane, i-China ne-United States, ibambe iqhaza kulolu cwaningo.Umnyango wethu wezifo zenhliziyo uhlonishwe ngokubamba iqhaza.Ingqikithi yeziguli ezingu-5,050 ezinokwehluleka kwenhliziyo okungapheli ezineminyaka engu-≥18 iminyaka, i-NYHA isigaba II-IV, i-EF <45%, namazinga aphezulu e-natriuretic peptide (NT-proBNP) phakathi kwezinsuku ezingu-30 ngaphambi kokungahleliwe, futhi ababelaliswe esibhedlela ngenxa yokwehluleka kwenhliziyo. phakathi nezinyanga ezingu-6 ngaphambi kwe-randomization noma i-diuretics enikezwe nge-intravenously ngenxa yokwehluleka kwenhliziyo phakathi nezinyanga ze-3 ngaphambi kwe-randomization yabhaliswa ocwaningweni, bonke bathola i-ESC, i-AHA/ACC, kanye nemihlahlandlela kazwelonke/yesifunda enconyiwe izinga lokunakekelwa.Iziguli zihlelwe ngokungahleliwe ngesilinganiso esingu-1:1 emaqenjini amabili futhi zanikezwaI-Vericiguat(n=2526) kanye ne-placebo (n=2524) ngaphezu kokwelashwa okujwayelekile, ngokulandelana.
Isiphetho esiyinhloko socwaningo kwakuyisiphetho esiyinhlanganisela sokufa kwenhliziyo noma ukulaliswa esibhedlela kwenhliziyo yokuqala;iziphetho zesibili zazihlanganisa izingxenye zokuphela okuyinhloko, ukulaliswa esibhedlela kwenhliziyo yokuqala nokulandelayo (izenzakalo zokuqala neziphindaphindiwe), ukuphela kwenhlanganisela yazo zonke izinkinga zokufa noma ukulaliswa esibhedlela kwenhliziyo, kanye nokufa kwembangela.Ekulandeleni okumaphakathi kwezinyanga eziyi-10.8, kube nokuncishiswa okungu-10% kwesiphetho esiyinhloko sokufa kwenhliziyo nemithambo yegazi noma ukulaliswa esibhedlela kokuqala kwenhliziyo eqenjini le-Vericiguat uma kuqhathaniswa neqembu le-placebo.