The effect of vericiguat on sudden cardiac death: insights from the VICTOR trial
Year: 2026
Type: article
Abstract: Sudden cardiac death constitutes a significant risk in patients with heart failure and reduced ejection fraction (HFrEF). This risk is proportionally higher in those with less advanced disease and is not confined to periods of clinical instability. Previous studies have shown that although the absolute risk of sudden cardiac death has declined over the past two decades with the use of evidence-based therapies, a sizable residual risk remains at ∼10% at 3 years in ambulatory patients with HF.1 Vericiguat, an oral soluble guanylyl cyclase stimulator, is currently recommended to reduce the risk of cardiovascular death or hospitalizations for heart failure (HHF) in patients with HFrEF and recent worsening, defined as either HHF within 6 months or need for outpatient intravenous diuretics within 3-months before screening. The Vericiguat Global Study in Participants with Chronic Heart Failure (VICTOR) trial addressed the role of vericiguat in ambulatory HFrEF patients without recent worsening.2 VICTOR was notable for the high use of guideline-directed medical therapy and implantable cardiac defibrillator (ICD) use at baseline.3 In VICTOR, while vericiguat did not statistically significantly reduce the primary composite endpoint of cardiovascular death or HHF, the risk for cardiovascular death (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.71–0.97) and all-cause death (HR 0.84, 95% CI 0.74–0.97) were lowered with vericiguat.2,4 Importantly, vericiguat lowered the risk of sudden cardiac death (1.6 versus 2.2 events per 100 patient-years; HR 0.75, 95% CI 0.56–0.99 in vericiguat versus placebo group, respectively). The sudden cardiac death benefit was observed early, at a median follow-up of 5.4 months after an accrual of 21 events (6 [0.4%] in vericiguat versus 15 [1.1%] in placebo group; HR 0.40, 95% CI 0.155–1.032; P = .0497) and persisted throughout the follow-up. In this exploratory sub-analysis of the VICTOR trial, we assessed the consistency of vericiguat effect on sudden cardiac death across demographics characteristics, comorbidities, estimated glomerular filtration rate (≥15–≤30 mL/min/1.73 m2 vs ≥30–≤60 mL/min/1.73 m2 vs ≥60 mL/min/1.73 m2), and mean left ventricular ejection fraction (<31% vs ≥31%). The impact of baseline guideline-directed medical therapy and ICD individually, and the number of guideline-directed medical therapy drugs (0–2 vs 3 vs 4) on mortality outcomes were also assessed. Separately for each subgroup level, we used Cox proportional hazard models, controlling for the stratification factor New York Heart Association class to evaluate heterogeneity of sudden cardiac death risk and competing modes of death. Forest plots were then used to display the results. Subgroup by treatment interaction P-values were derived from likelihood ratio tests based on Cox proportional hazard models, where the reduced models included treatment group, New York Heart Association class, and the subgroup as covariates. Among 6105 patients with HFrEF, the benefit of vericiguat on sudden cardiac death versus placebo was consistent across subgroups studied. In particular, consistency was shown between patients with ICD (HR 0.51, 95% CI 0.24–1.09) and without an ICD (HR 0.79, 95% CI 0.58–1.07; interaction P = .301), those with history of ischaemic heart disease (HR 0.70, 95% CI 0.49–1.01) and without (HR 0.82, 95% CI 0.52–1.30; interaction P = .600), and irrespective of baseline medical therapy with angiotensin receptor neprilysin inhibitor, beta-blocker, mineralocorticoid receptor antagonists, or sodium-glucose cotransporter inhibitor-2 (all treatment-by-outcome interaction P > .18). The benefit across the number of guideline-directed medical therapy drugs at baseline was also consistent (HR 0.81, 95% CI 0.44–1.49 for 0–2 drugs, HR 0.70, 95% CI 0.47–1.04 for 3 drugs, and HR 0.79, 95% CI 0.46–1.35 for 4 drugs, respectively; treatment-by-subgroup interaction P = .896). There was no evidence of heterogeneity across key subgroups (Figure 1). In an exploratory analysis of upstream clinical trajectory preceding sudden cardiac death, the latter was infrequently preceded by worsening HF events. Across 193 SCD events, only 26 patients (13.5%) had ≥1 HHF before death. Among those with prior HHF, the most recent HHF occurred a median of 132.5 days before death (interquartile range 75.0–230.0). Furthermore, 27 patients (14.0%) had a non-HF cardiovascular hospitalization (median 32.0 days from the most recent event to death), 14/193 (7.3%) had a non-cardiovascular hospitalization (median 198.5 days), and 53/193 (27.5%) had any all-cause hospitalization (median 86.0 days). Median baseline NT-proBNP was 1979 pg/mL (Q1–Q3: 1142–3223) and the most recent pre-death NT-proBNP was 1969 pg/mL (Q1–Q3: 1159–4306), with a median change from baseline of 0 pg/mL (−136 to 880). The proportions with ≥30% increase (32.1%) and any decrease (28.9%) were similar. Time to sudden cardiac death and risk reduction across subgroups. ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; ARNI, angiotensin receptor/neprilysin inhibitor; CI, confidence interval; eGFR, estimated glomerular filtration rate; GDMT, guideline-directed medical therapy; HFH, heart failure hospitalization; ICD, implantable cardioverter defibrillator; LVEF, left ventricular ejection fraction; MRA, mineralocorticoid receptor antagonist; NT-proBNP, N-terminal pro-B-type natriuretic peptide; NYHA, New York Heart Association; SGLT2i, sodium-glucose cotransporter-2 inhibitor In VICTOR, HHF was uncommon before sudden cardiac death, as only 26 sudden cardiac death events were preceded by at least 1 HHF, and when the latter happened, the most recent HHF typically occurred months before death. Consistent with this trajectory, other upstream causes of hospitalization were also infrequent before sudden cardiac death, and the time from the most recent all-cause hospitalization to sudden cardiac death remained relatively long. Taken together, upstream trajectory data preceding sudden cardiac death suggest that, in the VICTOR trial, sudden cardiac death was often not temporally coupled to a recent worsening HF event, demonstrating that the observed reduction in SCD with vericiguat is unlikely to be explained solely by prevention of clinical HF progression. NT-proBNP was mostly unchanged from baseline to the most recent assessment before death among patients experiencing sudden cardiac death. These data do not support a dominant pattern of escalating neurohormonal and haemodynamic stress immediately preceding sudden cardiac death in this cohort of stable HF patients. Therefore, vericiguat may reduce vulnerability to sudden cardiac death through mechanisms that are at least partially independent of immediate pre-terminal congestion. The benefit of risk reduction for sudden cardiac death is especially notable considering the overall lower risk population that was enrolled in VICTOR, including a high proportion of patients without a history of past HHF or remote HHF, almost a third of the participants were not on diuretics at baseline, almost 80% had New York Heart Association class II symptoms, and were receiving excellent guideline directed medical therapy at baseline, all of which have been associated with reduction in the risk of sudden cardiac death. Moreover, the magnitude of risk reduction (25% relative risk reduction) was clinically meaningful. The VerICiguaT Global Study in Subjects with Heart Failure with Reduced Ejection Fraction (VICTORIA), which enrolled a higher-risk population with recent HF decompensation, did not demonstrate a statistically significant reduction in cardiovascular death with vericiguat (HR for cardiovascular death 0.93, 95% CI 0.81–1.06).1 However, in a pre-specified post hoc analysis limited to the lower three natriuretic peptide quartiles, there was a nominally significant cardiovascular death benefit. Specifically, among patients with NT-proBNP levels below the highest quartile (≤5314 pg/mL), vericiguat was associated with an HR for cardiovascular death of 0.75 (95% CI: 0.60–0.94), while this effect was not observed in the highest quartile.5 In contrast with our findings, another post hoc analysis of VICTORIA showed a statistically significant reduction in sudden cardiac death risk (adjusted HR 0.64, 95% CI 0.43–0.96) in patients with ICD at baseline, which was consistent regardless of HF aetiology (ischaemic vs non-ischaemic HF).6 Pooled analyses of VICTORIA and VICTOR showed a reduction in cardiovascular death and SCD with vericiguat across the HFrEF risk spectrum.3 These benefits were seen consistently in patients with or without an ICD, history of coronary artery disease, or degree of baseline medical therapy for HFrEF. Although the point estimate for sudden cardiac death reduction was numerically larger in patients with ICD than in those without, there was no evidence of heterogeneity by ICD status (interaction P = .30). The absence of a statistically significant interaction should be interpreted cautiously, given limited event counts within subgroups. In addition, baseline ICD and cardiac resynchronization therapy prevalences among participants who experienced sudden cardiac death were 15.5% (30/193) and 6.7% (13/193), respectively, compared with 32.9% (1741/5288) and 14.5% (767/5288) in those who survived, suggesting that many sudden cardiac death events occurred in patients without device protection. However, the lack of interaction is clinically plausible because ICD do not prevent arrhythmia occurrence or non-shockable terminal rhythms, and in this context vericiguat may reduce arrhythmic burden/substrate, providing incremental benefit regardless of device status, as supported by emerging preclinical and clinical data.3,6–10 A limitation of our analysis is that outpatient worsening HF events were not available. Therefore, we were not able to evaluate subclinical congestion or non-hospitalized deterioration preceding sudden cardiac death. Nevertheless, the strong contrast in both frequency and proximity of HHF before sudden cardiac death provides clinically relevant context for interpreting the clinical trajectories before sudden cardiac death in the VICTOR trial. In conclusion, this analysis shows that even in the lower risk population of participants with HFrEF with high use of guideline-directed medical and device therapy at baseline, residual sudden cardiac death risk is considerable and is modifiable with vericiguat. The observed reduction in sudden cardiac death with vericiguat was mostly consistent across demographic characteristics, baseline comorbidities, and background medical and device therapy. Vericiguat may provide incremental benefit in reducing sudden cardiac death in ambulatory HFrEF patients, complementing foundational therapies. FF has nothing to disclose. FZ reports personal fees from 89bio, Applied Therapeutics, Bayer, Betagenon, Biopeutics, Boehringer, BMS, CVRx, Cardior, Cambrian, Cereno pharmaceutical, Cellprothera, CEVA, Merck, Northsea, Novartis, Novo Nordisk, Otsuka, Owkin, and Salubri; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Bayer, Boehringer, CVRx, Cellprothera, CEVA, and Merck; participates in a data safety monitoring board or advisory board for Merck/Acceleron; has equities at G3Pharmaceutical, Cereno, Cardiorenal, and Eshmoun Clinical Research; and is founder of Global CardioVascular Clinical Trialists. IB and AX are employees of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, and may own stock and/or stock options in Merck & Co., Inc., Rahway, NJ, USA. SC is employee of Bayer AG and may own stock and/or stock optionsin Bayer AG. JAE has received research grants and consulting fees from AstraZeneca, Bayer, Boehringer Ingelheim-Lilly, Merck, Amgen, CSL-Vifor, Carduirion, American Regent, Otsuka, Novo Nordisk, and Applied Therapeutics. CSPL has received research grants from the National Medical Research Council of Singapore, Novo Nordisk, and Roche Diagnostic; has received consulting fees from Alleviant Medical, Allysta Pharma, AnaCardio AB, Applied Therapeutics, AstraZeneca, Bayer, Biopeutics, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, CardioRenal, CPC Clinical Research, Eli Lilly, Impulse Dynamics, Intellia Therapeutics, Ionis Pharmaceutical, Janssen Research & Development LLC, Medscape/WebMD Global LLC, Merck, Novartis, Novo Nordisk, Prosciento Inc, Quidel Corporation, Radcliffe Group Ltd., Recardio Inc, ReCor Medical, Roche Diagnostics, Sanofi, Siemens Healthcare Diagnostics, and Us2.ai; has patent PCT/SG2016/050217 pending and patent US Patent No. 10702, 247; is a co-founder and non-executive director of Us2.ai; and has received stock or stock options from Us2.ai. RJM has received research support and honoraria from Bayer and Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA; and consulting fees from Abbott, Alleviant Medical, American Regent, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Cytokinetics, Fast BioMedical, Gilead, Innolife, Eli Lilly, Lexicon, Medtronic, Medable, Merck, Novartis, Novo Nordisk, Pfizer, Pharmacosmos, Relypsa, Reprieve Cardiovascular, Respicardia, Roche, Rocket Pharmaceuticals, Sanofi, Verily, Vifor, Windtree Therapeutics, and Zoll. CMO has received consulting fees from Abiomed, Merck, and Zealcare. IB is an employee of Bayer AG. JB has received consulting fees from Abbott, American Regent, Amgen, Applied Therapeutic, AskBio, Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardiac Dimension, Cardiocell, Cardior, Cardiorem, CSL Bearing, CVRx, Cytokinetics, Daxor, Edwards, Element Science, Faraday, Foundry, G3P, Innolife, Impulse Dynamics, Imbria, Inventiva, Ionis, Lexicon, Lilly, LivaNova, Janssen, Medtronics, Merck, Occlutech, Owkin, Novartis, Novo Nordisk, Pfizer, Pharmacosmos, Pharmain, Prolaio, Regeneron, Renibus, Roche, Salamandra, Sanofi, SC Pharma, Secretome, Sequana, SQ Innovation, Tenex, Tricog, Ultromics, Vifor, and Zoll; and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Novartis, Boehringer Ingelheim-Lilly, AstraZeneca, Impulse Dynamics, and Vifor. The data sharing policy, including procedures and restrictions, of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA (MSD), is available at https://externaldatasharing-msd.com/ The VICTOR trial was supported by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA and Bayer AG. VICTOR Primary Site Investigators / Primary Study Coordinators Argentina: Angela Romero Zarante / Yenisca Zambrano; Miguel Hominal / Martin Suarez; Ezequiel Vottero / Marcia Lopez; Oscar Montaña / Gloria Cendali; Marisa Vico / Erica Giozzi; Diego Aizenberg / Santiago Coussio; Diego Arakaki / Miriam Gelersztein. Australia: Scott McKenzie / Kathryn Stibilj; David Colquhoun / Gemma Macdonald; John Atherton / Lydia Lilwall; Carmine De Pasquale / Simeoni Thomas; Alicia Chan / Denise Healy; Brendan McQuillan / Natalya Beer. Austria: Dirk von Lewinski / Viktoria Rausch; Andreas Schober / Maria-Christine Leitgeb; Christopher Adlbrecht / Cordula Koehler; Johann Auer / Manuela Rossmaier; Moritz Mirna / Kristen Kopp. Brazil: Jose Saraiva / Carla Cristina Vicente; Pedro Schwartzmann / Gabriela Ilana; Aguinaldo Freitas / Sandra Costa; Lidia Moura / Fernanda de Liz; Ricardo Mourilhe Rocha / Roberta Coelho; Fabiana Marcondes-Braga / Talita Antunes; Marcus Simoes / Veronica Silva; Joao Souza / Grazielle Freire; Fábio Silveira / Tamyres Galvão; Euler Manenti / Carollainy Silva. Canada: Ronald Bourgeois / Karen Boyd; Thao Huynh / Caroline Boudreault; Michael Hartleib / Rebecca Otis; James Cha / Judy Otis; Michael Heffernan / Marie Birch; A. Shekhar Pandey / Samantha Armstrong; Ashok Mukherjee / Lubna Zakria; Marie-Claude Parent / Helene Brown; Doug Hayami / Deborah Keller; Stephen Allan Schaffer / Wendy Janz; Yves Pesant / Yanick Sardin-Laframboise; Justin Ezekowitz / Quentin Kushnerik; Annie Roy / Caroline Boudreault; Gilbert Gosselin / Nathalie Leblanc; Yaariv Khaykin / Debbie Nemtean; Gordon Moe / Carlos Fernando; Ying Sia / Amelie Bujold; Jonathan Howlett / Anusha Sasikumar; Elizabeth Swiggum / Noreen Lounsbury; Serge Lepage / Carl Fortier; Subodh Verma / Debbie Chen. Chile: Fernando Lanas / Pamela Figueroa; Gabriel Maluenda / Maria Vergara; Juan Prieto / Viviana Noriega; Luis Morales / Jessica Zapata; Patricio Yovaniniz / Marcela Grandon; Franco Appiani / Tatiana del Rio; Sergio Mellado / Claudia Alvarez; German Cruz / Sebastian Mino; Juan Carlos Palma Carvajal / Veronica Olguin; Paz Bourke / Maribel Toledo Grell; Hugo Marin / Sebastian Rios; Manuel Novajas / Macarena Carcamo Medina. China: Jingmin Zhou / Mingfeng Lu; Jiyan / / / / / / / / / / / / / / / / / Lu; / / / / / / / / / / / / / / / / / / / / / / / / / / / / Claudia Jose / / / Jessica Miguel / / de / Maria Juan Carvajal / Luis / Karen Juan / / / / / Martin / / / Martin / / / / / / / / / / / / / / / / / / / Nathalie / / / / / / / / / / / / / / Martin / / / / von / / / / Martin / / / / Maria de / / Johann / / Maria / / / / / / / / / / de / Juan / / / / / / Chan / / / / / / / / / / / / / Maria / / / / / / / / / / / / / / / / / / / / / / / / Roberta / / / / / De / / / / / / / / / / / / Maria / / Carlos / / de / Wendy / / Maria / / / Claudia Lopez; Pedro / Sergio del / Ricardo / / / / / / / New / / / Deborah / James / / / / / / / / Jose / del / Maria / / Maria / Luis / / / Lidia / / / / / / / / / / / / / / Jose / / / Luis / / / / / / / / / / Natalya / / / / / / Maria / Maria / / David / / / / / / / Deborah / / / / / / / / / De / / / / / / / / / / Diego / Jose / / / / / Paz / Cristina / / / de / Maria / / / / / / / Marcus / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / Sandra / / / / / Brown; Justin / Christopher / / / / / / Deborah / / Rebecca / Angela / / David / / / / / / David / / Jose / James / / / Marie / Luis / / / Marcus / / / / / / / / / / / John / / / / / Alicia / / / / / / / / / / / / / David / / / / / / / / / / / Christopher / / / / / / Christopher / Armstrong; / / / / / / / / / / Scott and Research of Medical Bayer AG Justin of Merck & Co., James Medical of Scott and Research of Medical of Global of of Bayer AG Justin of National Heart Singapore, Medical Medical Merck & Co., Clinical Research of Christopher Heart and Medical of James Medical of A. Heart Failure Research of Merck Global Clinical Development Merck Global Clinical Development Merck Global Clinical Development Merck Global Clinical Development Vericiguat Merck Global Clinical Study Merck Global Clinical Clinical Merck Global Clinical Merck and Research Merck and Research Vericiguat Medical Merck Global Clinical De Merck Global Clinical Merck Global Clinical Lydia Clinical Bayer AG Maria of and Bayer AG Bayer AG Argentina: Marisa Australia: Scott Austria: Dirk von Brazil: Fabiana Canada: Chile: Fernando China: Juan New Jose David Karen Marisa of Diego Medical of & Medical of Research of Association of of and Clinical of of Maria Medical Heart Heart Michael Karen David Clinical Research
DOI: 10.1093/ejhf/xuag049
Authors: Francesco Fioretti, Faiez Zannad, Irina Barash, Stefano Corda, Justin A Ezekowitz, Carolyn S P Lam, Robert J Mentz, Christopher M O’Connor, Inga Bayh, Aiwen Xing, Javed Butler, for the VICTOR Study Group, Angela Romero Zarante, Yenisca Zambrano, Miguel Hominal, Martin Suarez, Ezequiel Vottero, Marcia Lopez, Oscar Montaña, Gloria Cendali, Marisa Vico, Erica Giozzi, Diego Aizenberg, Santiago Coussio, Diego Arakaki, Miriam Gelersztein, Scott McKenzie, Kathryn Stibilj, David Colquhoun, Gemma Macdonald, John Atherton, Lydia Lilwall, Carmine De Pasquale, Simeoni Thomas, Alicia Chan, Denise Healy, Brendan McQuillan, Natalya Beer, Dirk von Lewinski, Viktoria Rausch, Andreas Schober, Maria-Christine Leitgeb, Christopher Adlbrecht, Cordula Koehler, Johann Auer, Manuela Rossmaier, Moritz Mirna, Kristen Kopp, Jose Saraiva, Carla Cristina Vicente, Pedro Schwartzmann, Gabriela Ilana, Aguinaldo Freitas, Sandra Costa, Lidia Moura, Fernanda de Liz, Ricardo Mourilhe Rocha, Roberta Coelho, Fabiana Marcondes-Braga, Talita Antunes, Marcus Simoes, Veronica Silva, Joao Souza, Grazielle Freire, Fábio Silveira, Tamyres Galvão, Euler Manenti, Carollainy Silva, Ronald Bourgeois, Karen Boyd, Thao Huynh, Caroline Boudreault, Michael Hartleib, Rebecca Otis, James Cha, Judy Otis, Michael Heffernan, Marie Birch, A Shekhar Pandey, Samantha Armstrong, Ashok Mukherjee, Lubna Zakria, Marie-Claude Parent, Helene Brown, Doug Hayami, Deborah Keller, Stephen Allan Schaffer, Wendy Janz, Yves Pesant, Yanick Sardin-Laframboise, Justin Ezekowitz, Quentin Kushnerik, Annie Roy, Caroline Boudreault, Gilbert Gosselin, Nathalie Leblanc, Yaariv Khaykin, Debbie Nemtean, Gordon Moe, Carlos Fernando, Ying Sia, Amelie Bujold, Jonathan Howlett, Anusha Sasikumar, Elizabeth Swiggum, Noreen Lounsbury, Serge Lepage, Carl Fortier, Subodh Verma, Debbie Chen, Fernando Lanas, Pamela Figueroa, Gabriel Maluenda, Maria Vergara, Juan Prieto, Viviana Noriega, Luis Morales, Jessica Zapata, Patricio Yovaniniz, Marcela Grandon, Franco Appiani, Tatiana del Rio, Sergio Mellado, Claudia Alvarez, German Cruz, Sebastian Mino, Juan Carlos Palma Carvajal, Veronica Olguin, Paz Bourke, Maribel Toledo Grell, Hugo Marin, Sebastian Rios, Manuel Novajas, Macarena Carcamo Medina, Jingmin Zhou, Mingfeng Lu, Jiyan Chen, Yihan Jiang, Junkui Wang, Yuhong Kang, Luping Jiang, Yuxin Zhong, Wei Jin, Shanshan Jin, Jianzeng Dong, Jiajia Wang, Jianqiang Peng, Xiaomei Peng, Aijie Hou, Ruili Duan, Weihong Jiang, Xiaowei Zhou, Xiang Gu, Wenjuan Dai, Yibin Mei, Miaoxia Liu, Jing Yu, Jinxia Chen, Zuyi Yuan, Yuhong Kang, Aidong Shen, Yutao Wang, Ruiping Zhao, Peiyan Ren, Zhuhua Yao, Xiying Zhang, Jingfeng Wang, Huijun Ouyang, Maohua Chen, Yu Lu, Peizhi Miao, Zhenfei Chen, Zhouqing Huang, Xiaoli Teng, Jiahong Wang, Xuyao Yan, Biao Xu, Yue Gao, Ping Qiao, Mizozhu Han, Mingya Liu, Mingya Liu, Shaorong Wu, Ruihao Li, Qian Liang, Zhengzheng Ni, Qilin Ma, Ting Li, Hongliang Cong, Chuangting Zhu, Guangping Li, Lin Liu, Weimin Li, Junsheng Jing, Qing Zhang, Jia Tang, Cuimei Zhao, Liao Ting, Xiaosheng Hu, Yao Fang, Yuehui Yin, Xuejun Liu, Jun Jiang, Mengqing Zhang, Yuanyuan Luo, Siqi Wang, Ping Zhang, Peng Zhang, Yanqing Wu, Wenting Wei, Xiaohua Pang, Yanqiong Xia, Lihong Wang, Chenyu Lv, Zhihua Fang, Qiaochu Du, Ping Yang, Xuejiao Liu, Wei Yuan, Min Wang, Kai Huang, Danli Xiang, Likun Ma, Jinxiu Liu, Clara Saldarriaga, Claudia Garcés Restrepo, Jose Accini, Yineth Conrado Ortega, Rodrigo Botero, Aleydy Caceres, Alberto Cadena, Jessica Martinez, Miguel Moncada Corredor, Leisa Florez, Camilo Arana, Lizzette Diaz Villegas, Dora Molina de Salazar, Maria Valencia, Juan Carvajal, Paola Delgado, Luis Echeverria, Karen Bueno Diaz, Juan Gomez-Mesa, Laura Trujillo, Eduardo Echeverry, Adriana Escruceria, Melissa Reyes Dia, Adriana Cervantes Hurtado, Ladislav Busak, Blanka Pokorna, Vojtech Melenovsky, Anna Kuprova, Martin Hajsl, Jana Brindova, Roman Miklik, Veronika Musilova, Libor Nechvatal, Libor Nechvatal, Martin Radvan, Renata Machova, Jan Belohlavek, Petra Zavadilova, Zdenek Monhart, Lenka Bouzkova, Tomas Drasnar, Matej Fald, Nora Bolvanska, Helena Packova, Jan Krejci, Jana Roche, Jens Hove, Lotte Ring, Morten Lindhardt, Therese Bang-Hansen, Jens Due Lomholdt, Kari Niemann, Kristian Madsen, Joan Hummelshoej, Kenneth Egstrup, Linda Hindsgaul, Morten Schou, Jette Madsen, Søren Nielsen, Emilie Jakobsen, Henrik Wiggers, Marianne Leth, Lars Kober, Elsebet Eriksen, Niels Eske Bruun, Winnie Kragh, Jens Bronnum-Schou, Pia Hadsund, Henrik Vadmann, Annette Nielsen, Michel Galinier, Nathalie Rosolin, Jean-Michel Tartiere, Pauline Armangau, Emile Ferrari, Nassima Belkacem, Cadi Aludaat, Line Balaya-Gouraya, Emmanuelle Berthelot, Agnes Pezzi, Nicolas Girerd, Emilie Tachot, Teodora Dutoiu, Anne-Sophie Derien, Emmanuel Boiffard, Philippe Prunier, Francois Picard, Manel Moumni, Richard Isnard, Ghoulem Tabdjoun, Nathan Mewton, Bianca Barry, Arne Geissler, Jeanette Schumacher, Peter Schwimmbeck, Bianca Krug-Hoeren, Dimitrios Dimitroulis, Judith Simons, Jan-Malte Sinning, Julia Müller, Martin Duersch, Daniela Leyh, Stefan Stork, Elisa Wied, Ulrich Overhoff, Mariana Rupprecht, Hannes Lindemann, Ines von Hertell, Werner Rieker, Jelena Anacker, Henning Ebelt, Ute Goebel, Alexander Jabs, Stephanie Kirchenwitz, Christian Mahnkopf, Mario Hahn, Martin Bergmann, Cecile Bosredon, Mirko Brudzinski, Katja Steinbruegger, Axel Linke, Kerstin Eck, Daniel Beug, Maria Gonzalo de Juan, Kerstin Schadow, Nicole Schaefer, Norbert Frey, Benjamin Schafer, Johann Bauersachs, Alexandros Markakis, Katrin Eberhard, Maria Karmpalioti, Dimitrios Tziakas, Vaggelitsa-Eirini Kesoglou, Konstantinos Tsioufis, Ilias Gkartzonikas, Sotirios Patsilinakos, Pinelopi Karagogou, Aikaterini Naka, Petros Nikolopoulos, Ioannis Skoularigkis, Foteini Ereliadou, Gerasimos Filipatos, Paraskevi Lathridou, Vlasios Ninios, Evangelia Androutsou, Haralampos Karvounis, Vasiliki Moutafi, Alexandros Briasoulis, Christin Mandila, Elias Tsougos, Lissette Garcia de Krumbach, Apostolos Karavidas, Mayra Aguilar Schinini, Juan Arango Benecke, Andrea Lucia Ramírez Ávila, Pablo Montenegro Valdovinos, Xue Ting Wang, Marco Rodas Diaz, Venus San Lui Ho, Pui-Wai Alex Lee, Eva Tam, Siu Han Jojo Hai, Kar Wai Lee, Katherine Yue Yan Fan, Zsolt Nagy, Ngai-Yin Chan, Karolyne Rozsa Toth, Sandor Kancz, Krisztina Toth, Robert Kirschner, Laura Kósa-Hóbor, Ferenc Lakatos, Barna Bartha, Bela Merkely, Gabriella Bencze, Andras Papp, Gabor Kiss, Zsolt Zilahi, Szilvia Kovacs, Istvan Kovacs, Szilvia Levang, Tunde Toth, Monika Nagy, Tamas Habon, Réka Kónyi, Janos Takacs, Nora Hadi, Attila Konyi, Katalin Spandli, Bela Benczur, Maria Szabone Nagy, Botond Literati-Nagy, Arpad Kormanyos, Andras Nagy, Gyongyver Ibolya Mihaly, Robert Sepp, Anita Kalapos, Ebrahim Noori, Jan Mayene Abalos, Attila Thury, Joanne Maher, Ross Murphy, Neda Nabwani, Kenneth McDonald, Hadas Even Nir, Shaul Atar, Galit Paor, Tuvia Ben Gal, Meital Biener, Oren Caspi, Shiree Yedid Am, Sorel Goland, Jenny Elber, Tal Hasin, Ira Lapidus, Jameel Mohsen, Dema Barhum, Gil Moravsky, Sapir Swisa, Donna Zwas, Nava Eizenberg, Alexander Goldman, Marilisa Ambrosio, Alexander Fardman, Noemi Punzo, Michele Senni, Irene Mattavelli, Alessandro Fucili, Luca Assoni, Piergiuseppe Agostoni, Valentina Morsella, Savina Nodari, Marta Maffi, Maurizio Volterrani, Ilaria Gallelli, Laura Scelsi, Michela Algeri, Claudio Borghi, Roberta Famiani, Alessandro Maloberti, Federica Ramani, Stefano Carugo, Francesca Vannuccini, Gianfranco Sinagra, Caterina Scapicchi, Alberto Palazzuoli, Giuditta Cuccuru, Giuseppe Ambrosio, Francesca D'Alessandro, Gaetano de Ferrari, Manhaiyun Suhaimi, Roberto Badagliacca, Juriah Sulehan, Imran Zainal Abidin, Fatma Diyana Mohd Bukhari, Tiong Kiam Ong, Nur Alia, Khairani Siti, Zainal Abidin, Neoh Poh Tiew, Shariff Raja, Ezman Faridz Shariff, Zalida Mamat, Abd Syukur Abdullah, Mabelle Wong, W Isa, W Yus Haniff, Nurul Suhaili Mamat, Houng Bang Liew, Haydea Hirata Avila, Ahmad Wazi Ramli, Ma Aguilar Sanchez, Gustavo Mendez Machado, Hannah Guzman Solorzano, José Arenas León, Michelle Meza Hernandez, Maria Arias Mendoza, Rosa Flores Pruneda, Enrique Lopez Rosas, Carlos Castro Zarate, Alberto Bazzoni Ruiz, Ana Rosa Ramos Ruiz, Jesus Perez Rios, Lucia de la Vega, Armando Segura Gonzalez, Wendy Mendez, William Gandoy Vazquez, Luz Belen Garcia Gonzalez, Hilda Peralta Rosado, Maria Maytorena, Alberto Varela Varela, Elena Ruiz Rubio, Paul Vazquez, Nazareth Goiz, Jaime Chavez Michel, Claudia Lopez, Pedro Fajardo Campos, Sergio del Muro Munoz, Jesus Illescas Diaz, America Medina Reyes, Ricardo Garcia, Araceli Cuevas, Hector Salazar Lopez, Ana García Briones, Norberto Matadamas, Edgar Barcenas, Castelán Vargas, Marcos Astorga Rivas, Edmundo Bayram Llamas, Felipe Olguin Ortiz, Gerardo Payro, Geraldine González, Eduardo Zambrano Ruiz, Arianna Rodriguez Cal Y Mayor, Alejandro Ricalde, Stephanie Rose, Marcelo Ramirez Mendoza, Jo-Anne Kovacs, Richard Troughton, Deborah Scott, Katherine Ferrier, Sharon Jaques, James Pemberton, Cathy Hulbert, Vijay Dhakshinamurthy, Jamie Duckworth, Nezar Amir, Danica Kistanna, Mansi Turaga, Sonia Romero, Jocelyne Benatar, L Jeanneth Rodriguez, Aldo Edwin Rodriguez Escudero, Jill Espejo, Felix Medina Palomino, Carola Ariza Villanueva, Libia Lu Galarreta, Milagros Matta, Jose Cabrera, J Zena, Norma del Rosario, Armando Godoy Palomino, Maria Garcia, Roger Correa, Leonila Castillo, Percy Berrospi, Maria Gil Rescavarren, Luisa Cardoza Anton, Bozena Chromczak, Luis Camacho Cosavalente, Paulina Idzikowska, Zbigniew Pijanowski, Joanna Wilczynska, Grzegorz Skoczylas, Monika Tunkiewicz, Lidia Pawlowicz, Alina Cieszynska, Joanna Szachniewicz, Wojciech Zajdel, Krzysztof Cymerman, Agnieszka Polak, Wojciech Zajdel, Marta Augustyn, Aleksander Zurakowski, Anna Ryznar-Sicinska, Robert Witek, Natalia Markiewicz, Stanislaw Mazur, Anna Beme, Tomasz Lugowski, Pawel Walasek, Beata Miklaszewicz, Urszula Matys, Jacek Gniot, Monika Rolirad, 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Comin-Colet, Paz Gonzalez Portilla, Josebe Goirigolzarri Artaza, Cristina Soler, Jesus Alvarez Garcia, Paloma Gastelurrutia, Nuria Farre Lopez, Guiomar Mediavilla Garcia, Antoni Bayes Genis, Zulaica Grille Cancela, Esteban Lopez de Sa Areses, Kristina From, Maria Generosa Crespo Leiro, Pernilla Haglund, Niklas Bergh, Malin Broberg, Barna Szabo-Soderberg, Kristina Eriksson, Carl-Johan Lindholm, Carina Andersson, Niclas Svedberg, Isabel Tronstad, Ingemar Lonnberg, Håkan Södergren, Emil Najjar, Birgitta Rangman, Marcus Lind, Chiao-Wen Chang, Ake Olsson, Vinny Chou, Chern-En Chiang, Huey-Pyng Su, Ming-En Liu, Ping-Ping Chou, I-Chang Hsieh, Hui-Ling Huang, Jin-Long Huang, Hsiao-Ting Lee, Tsung-Hsien Lin, Akin Aydin, Chien-Hsun Hsia, Burcu Kaygusuz, Yuksel Cavusoglu, Selin Yildirim, Bahar Tak, Özge Durhan, Sanem Nalbantgil, Emel Sahin, Ahmet Celik, Ebru Sahin, Hakan Altay, Fatma Nur Ertunc, Ersel Onrat, Gizem Celik Eminoglu, Cihan Altin, Esmanur Mizrak, Tayfun Sahin, Bulut Akbulut, Ergun Baris Kaya, Ezgi Aslan, Hasan Barman, Berna Akin, Vineet Venugopal, Iulia Volchyk, Thomas Duythuc To, Taras Chendey, Oleksandr Kulbachuk, Mishka Pavelko, Roman Stets, Olena Beregova, Mykola Rishko, Oksana Pysanko, Andriy Yagensky, Yaroslav Lutai, Leonid Rudenko, Ganna Rudya, Dmytro Reshotko, Andriy Yurkiv, Oleksandr Parkhomenko, Oksana Gliebova, Larysa Mishchenko, Diana Schyhypak, Olena Levchenko, Halyna Havryliuk, Oleksandr Prokhorov, Oksana Bilonko, Oleksandra Donets, Alla Dzyba, Halyna Myshanych, Olha Radchenko, Sergii Shevchuk, Andrii Danyliuk, Ivan Vyshnyvetskyy, Tetiana Danko, Vira Tseluyko, Taras Petrovskyy, Andrii Klantsa, Volodymyra Sovtus, Anna Kulyk, Tetiana Shandra, Roman Petrovskyy, Elena Romanova, Igor Vakaliuk, Denys Babichev, Svitlana Zhurba, Ganna Krotenko, Oleg Sychov, Nataliia Kumpan, Iurii Rudyk, Svitlana Trubina, Ozlem Yildirimturk, Sandra Elphick, Ahmet Genc, Alexandra Florou, Ahmet Fuat, Rita Adrego, Craig Barr, Sinead Lyons, Theresa McDonagh, Sarah Broadhead, Lisa Anderson, Joanna Brown, Justin Cooke, Michelle Kinnin, Christopher Cassidy, Francis Galera, Andrew Moriarty, Abeesh Panicker, Ify Mordi, Lisa Mellish, Manish Saxena, Susan Crawford, Prithwish Banerjee, Rosemary Harper, Matthew Dewhurst, Deborah Jones, Madhusudhan Varma, Ben Jones, Bassem Ibrahim, Rebecca Cutts, Aaron Wong, Angela Doughty, Rumi Jaumdally, Susan Regan, Patrick Moore, Lani Holman, David Wilson, Cynthia Larew, Patrick Donnelly, Haydee Gutierrez, Mohsin Alhaddad, Phillippa McCartney Morales, Linda Cadaret, Jorge Allina, Mehrdad Ariani, Sajad Hamal, Rasha Youssef, Maite Ramirez, David Bernard, Madeline Peek, Matthew Budoff, Kelli Clopp, Jose Cardona, Jaime Wyatt, James Feldman, Stephanie Lambert, Ferris George, Beatriz Penafiel, Eve Gillespie, Marie Reno, Obinna Isiguzo, Linda Schwarz, Luis Martinez, Rose Hroncich, Usman Qayyum, Donna Winterrowd, Renee Sangrigoli, Sabrina Forbus, Marcus Williams, Kevin Thornton, Ravi Bhagwat, Crystal Dubois, Brian Foley, Heather Maschenik, Ashish Gangasani, Moravia Vasallo, Naseem Jaffrani, Anne Dirks, Felix Sogade, Lauren Stamschror, Javier Vasallo, Leigha Hughes, Gregory Ewald, Mohamed Khalil, Majdi Ashchi, Nancy Fry, Sandeep Khosla, Heather Blubaugh, Hahn Bui, Smelda Ferrin, John McGinty, Rafael Muro, Jesse Doran, Abeer Abu-Saif, Dennis Spiller, Jennifer Bajornas, Hamid Taheri, Marisol Ramos, Imad Hariri, Alicia Phillips, Ataul Qureshi, Jill Schulte, Narendra Singh, Vicky Parfait, Andrea Phillips, Malcolm Lust, Juliane Vierecke, Margie McKercher, Peter Fail, Jacqueline Killian, Robert Long, Victoria Smith, Ramon Lloret, Rema Iskandarani, Nabil Dib, Breanna Culver, Siby Ayalloore, Ali Muhammad, Katherine Michelis, Stephanie Alford, Fahed Bitar, Amy King, Lokesh Chandra, Richard Jackson, Vijay Rao, Hailey Jenkins, David Hotchkiss, Yulia Abidov, Richard Jackson, Ariel Quebedeaux, Matthew Janik, Sharyce Hayes-Jones, Marcel Zughaib, Teresa Osmulski, Wade May, Natalie Fiallo, Dilip Viswanath, Emily Gilder, Alexander Adler, Amanda Reynolds, Joshua Larned, Ashley Williams, Joseph Surber, April Howarter, Mark Napoli, Robert Edmond, Wayne Old, Alison Solomon, Christopher Sparrow, Mihret Assefa, Divya Gupta, Nicole Scott, Glenn Hamroff, Sirisha Tirumanisetti, Chrisette Dharma, Shelli Roberts, William Herzog, Lynett Zachary, Iyad Isseh, Loren Moore, Christopher Daniels, Kimberly Armstrong, Lars Runquist, Svetlana Strugatsky, Ghiyath Tabbal, Nehal Vekariya, Andre Artis, Ramona Stevens, Freny Mody, Ibraheem AlAjlouni, Pankaj Arora, Peter Osmond, Mahfouz El Shahawy, Yasmire Evans, Ghiath Mikdadi, Nadine Kallas, Joseph Izzo, Iluyomade Adeusi, Anu Lala-Trindade, Lisa English, Brian Bostick, Anastasiia Piskun
Institutions: Baylor Scott & White Research Institute, Université de Lorraine, Merck & Co., Inc., Rahway, NJ, USA (United States), Bayer (Switzerland), University of Alberta, Canadian VIGOUR Centre, National University of Singapore, National University Heart Centre Singapore, National Heart Centre Singapore, Duke Clinical Research Institute, Inova Health System, University of Mississippi
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,300
Funders: Amgen, Bristol-Myers Squibb, Eli Lilly and Company, Pfizer, AstraZeneca, Bayer, Sanofi, Gilead Sciences, Boston Scientific Corporation, Regeneron Pharmaceuticals, LivaNova, Acceleron, Cytokinetics, ReCor Medical, Verily Life Sciences, Impulse Dynamics, Abiomed, Novo Nordisk, Astellas Pharma, American Regent, Respicardia, Medical Research Council, National Medical Research Council, Relypsa
OpenAlex ID: W7140219932