Page 58 - ITPS-8-2

INNOSC Theranostics and
Pharmacological Sciences Management of heart failure in Pakistan

Table 3. Challenges and considerations in implementing vericiguat therapy for heart failure with reduced ejection fraction in
Pakistan: accessibility, education for healthcare providers, and regulatory approval
Challenges and Description References
Considerations
Accessibility and affordability Ensuring that vericiguat is readily available and affordable to patients in Pakistan 21
by taking into account the economic factors and accessibility of healthcare
infrastructures.
Education for healthcare Providing information and training to healthcare professionals in Pakistan on the 21
providers appropriate use of vericiguat as a treatment for heart failure.
Regulatory approval process Navigating the regulatory approval process in Pakistan to ensure that vericiguat 21
meets safety and efficacy standards for use in heart failure treatment.

Figure 2. Summary flowchart for the efficacy, safety, and application of vericiguat for the management of heart failure with reduced ejection fraction. Image
created by authors.
Abbreviations: BP: Blood pressure; HF: Heart failure; HFrEF: Heart failure with reduced ejection fraction; LF: Left ventricle; NO: Nitric oxide; sGC: Soluble
guanylate cyclase.

HFrEF. In individual patients with HFrEF, particularly those However, to fully comprehend its effectiveness when used
24
at higher risk for HF hospitalization, the addition of vericiguat with other medications such as valsartan and sacubitril, more
to the treatment regimen may be considered. However, research is needed.
25
the effectiveness of the combination of vericiguat with
sacubitril and valsartan in HFrEF is currently unknown. In 4. Future perspective for vericiguat in
26
Pakistan, the use of vericiguat could enhance cardiac disease Pakistan
management by exerting a targeted pharmacological effect, Considering Pakistan’s high rate of HF, integrating
specifically by increasing the sensitivity of soluble guanylate vericiguat into clinical practice may have a significant
cyclase (sGC) to endogenous nitric oxide (NO), thereby impact on patient outcomes and healthcare systems. HF
improving heart function. Vericiguat has the potential to and other cardiovascular diseases are becoming more
23
improve outcomes for individuals with HFrEF, especially common in Pakistan, a situation that calls for creative and
in terms of lowering hospitalizations and cardiovascular practical solutions. Due to its distinct mode of action and
27
deaths. Its implementation in Pakistan might improve encouraging outcomes from clinical trials, vericiguat is a
1
patient outcomes and the management of heart disease. solid contender for inclusion in national HF management

Volume 8 Issue 2 (2025) 52 doi: 10.36922/itps.3756