. In the VICTORIA trial, vericiguat reduced the risk of cardiovascular mortality and heart failure (HF) hospitalization among patients with heart failure with reduced ejection fraction (HFrEF) and a recent worsening heart failure event (WHFE). The representativeness of VICTORIA population to patients with WHFE in clinical practice is unknown.

. Patients with HF and ejection fraction <45% were identified in the PINNACLE registry and stratified by the occurrence of WHFE. Characteristics and outcomes of PINNACLE patients with and without a WHFE were compared to the VICTORIA population. Of the 14,180 PINNACLE patients with HFrEF identified, 26.5% had a WHFE. The VICTORIA population was similar to PINNACLE patients with a WHFE in mean age (67.3 vs. 66.7), ejection fraction (28.9% vs. 28.3%), body mass index (26.8 vs. 27.6), and comorbidity burden. The rate of HF hospitalization at 1 year was 29.6% in the placebo group of VICTORIA, compared to 35.8% in PINNACLE patients with a WHFE and 13.3% in patients without a WHFE.

. The PINNACLE patients with a WHFE meeting the VICTORIA definition resembled the VICTORIA population in characteristics and outcomes, suggesting that VICTORIA's population may be generalizable to patients with a WHFE in clinical practice.