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Vericiguat did not reduce the risk of cardiovascular mortality and hospitalization in heart failure with reduced ejection fraction, fewer cardiovascular deaths and all-cause deaths were observed. Host, Dr Harriette Van Spall (McMaster University, CA) is joined on-site at ESC Congress 2025 in Madrid by Dr Faiez Zannad (University of Lorraine, FR) to discuss pivotal results from the VICTOR (NCT05093933) trial. The VICTOR programme assessed vericiguat (MK-1242) safety and efficacy in 6105 heart failure with reduced ejection fraction patients, encompassing both acute decompensated and chronic stable populations. The trials compared three vericiguat dosing regimens (2.5, 5.0, and 10.0 mg once daily) against placebo, measuring time to first occurrence of the composite primary endpoint of cardiovascular death or heart failure hospitalisation. Findings showed that over 18.5 months follow-up, the primary outcome event of cardiovascular death or HF hospitalization had occurred in 18% of patients in the vericiguat group, and 19.1% of patients on the placebo group. Although vericiguat did not improve the primary composite endpoint, there were fewer cardiovascular deaths and all-cause deaths, supporting the use of the drug in ambulatory patients with HFrEF in addition to contemporary therapies. Recorded onsite at ESC Congress 2025 in Madrid. Editors: Jordan Rance and Yazmin Sadik. Videographers: Mike Knight, Dan Brent, Oliver Miles, Tom Green, David-Ben-Harosh. Support: This is an independent interview produced by Radcliffe Cardiology. Visit Radcliffe Cardiology: https://www.radcliffecardiology.com/ This content is intended for healthcare professionals only. Radcliffe brings medical knowledge, insight and innovation to life for CV clinicians around the world, using our communications & creative expertise, our platforms and connections across the community to help transform theory into practice faster. Like us on Facebook: / radcliffecardiology Follow us on X: https://x.com/radcliffeCARDIO