AIM Describe the distinguishing features of heart failure (HF) patients with reduced ejection fraction (HFrEF) in the VICTORIA (Vericiguat Global Study in Patients with Heart Failure with Reduced Ejection Fraction) trial. METHODS AND RESULTS Key background characteristics were evaluated in 5050 patients randomized in VICTORIA and categorized into three cohorts reflecting their index worsening HF event. Differences within the VICTORIA population were assessed and compared with PARADIGM-HF (Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) and COMMANDER HF (A Study to Assess the Effectiveness and Safety of Rivaroxaban in Reducing the Risk of Death, Myocardial Infarction, or Stroke in Participants with Heart Failure and Coronary Artery Disease Following an Episode of Decompensated Heart Failure). VICTORIA patients had increased risk of mortality and rehospitalization: New York Heart Association class (40% class III), atrial fibrillation (45%), diabetes (47%), hypertension (79%) and mean estimated glomerular filtration rate of 61.5 mL/min/1.73 m2 . Baseline standard of HF care was very good: 60% received triple therapy. Their N-terminal pro-B-type natriuretic peptide was 3377 pg/mL [interquartile range (IQR) 1992-6380]. Natriuretic peptides were 30% higher level in the 67% patients with HF hospitalization <3 months, compared to those within 3-6 months of HF hospitalization and those randomized after recent outpatient intravenous diuretic therapy. Overall the median MAGGIC (Meta-Analysis Global Group in Chronic Heart Failure) risk score in VICTORIA was 23 (IQR 18-27) as compared to the MAGGIC risk score in PARADIGM-HF of 20 (IQR 16-24). CONCLUSIONS VICTORIA comprises a broadly generalizable high-risk population of three unique clinical strata of worsening chronic HFrEF despite very good HF therapy. VICTORIA will establish the role of vericiguat, a soluble guanylate cyclase stimulator, in HFrEF.

中文翻译：

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VICTORIA（对射血分数降低的心力衰竭受试者进行的全球全球研究）试验的基线特征。

目的在VICTORIA（射血分数降低的心力衰竭患者的全球全球研究）试验中描述射血分数降低（HFrEF）的心力衰竭（HF）患者的区别特征。方法和结果对5050例在VICTORIA中随机分组的患者进行了关键背景特征评估，并将其分为三组，以反映他们的HF事件恶化的指标。评估了VICTORIA人群的差异并将其与PARADIGM-HF（ARNI与ACEI的前瞻性比较，以确定对心力衰竭的全球死亡率和发病率的影响）和COMMANDER HF（评估利伐沙班降低风险的有效性和安全性的研究）进行了比较死亡，心肌梗塞，失代偿性心力衰竭发作后患有心力衰竭和冠状动脉疾病的参与者的中风或中风）。VICTORIA患者的死亡和再次住院风险增加：纽约心脏协会（III级）（40％），房颤（45％），糖尿病（47％），高血压（79％），平均肾小球滤过率估计为61.5 mL /最小/1.73平方米 HF护理的基线标准非常好：60％接受了三联疗法。它们的N端前B型利钠尿肽为3377 pg / mL [四分位间距（IQR）1992-6380]。与HF住院3-6个月内和最近门诊静脉利尿剂治疗后随机分组的67％HF住院<3个月的患者相比，利钠肽水平高30％。总体而言，VICTORIA中的MAGGIC（慢性心力衰竭的荟萃分析全球组）风险评分中位数为23（IQR 18-27），而PARADIGM-HF的MAGGIC风险评分为20（IQR 16-24）。结论尽管有很好的HF治疗方法，VICTORIA还是由广泛的，普遍存在的高风险人群组成，由三个独特的慢性HFrEF恶化的临床阶层组成。维多利亚将在HFrEF中确立Vericiguat（一种可溶性鸟苷酸环化酶刺激剂）的作用。