Vericiguat in Heart Failure and the VICTOR Trial, With Javed Butler, MD

At the European Society of Cardiology Congress 2025 in Madrid, hosts Steve Greene, MD, and Muthiah Vaduganathan, MD, MPH, sat down with Javed Butler, MD, to review the results of the highly anticipated VICTOR trial, a companion study to the pivotal VICTORIA trial evaluating vericiguat in heart failure with reduced ejection fraction (HFrEF). While VICTORIA focused on patients recently hospitalized or otherwise destabilized, VICTOR deliberately enrolled the opposite population—ambulatory, stable patients, systematically excluding anyone with a recent hospitalization or outpatient IV diuretic use. As Butler noted, this created one of the most stable trial cohorts in HFrEF to date, with nearly 90% of participants free from hospitalization for over a year at baseline. Key Timestamps: 00:00 - Introduction 00:51 - Explaining the Patient Cohort 03:13 - The VICTORIA Trial 03:44 - Designing the VICTOR Endpoint 06:08 - Event Rates in Design Versus Execution 07:54 - VICTOR Results and Interpretation 10:34 - Reducing Heart Failure Mortality Without Impacting Hospitalization 15:57 - Is Worsening HF So Different from Outpatient HF? 17:29 - VICTOR Related to Mortality Reducing Therapies 20:15 - Is Vericiguat Not Primarily a Heart Failure Drug? 22:31 - Overlapping Pathways

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