The Impact of Vericiguat on Microvascular Function in Patients with Documented Vasospastic Angina Pectoris

Summary

Vasospastic angina is increasingly recognized as an important contributor to anginal symptoms in patients with non-obstructive coronary artery disease (ANOCA). Endothelial dysfunction and smooth muscle cell dysfunction are considered elementary in the development of vasospastic angina. As one of many functions, the vascular endothelium regulates local vascular tone, mainly through the vasodilatory effect of endothelium-derived nitric oxide (NO). Vericiguat is a soluble guanylate cyclase (sGC) stimulator and thereby acts directly on the NO signalling pathway from the endothelium towards the vascular smooth muscle cells. As such, Vericiguat potentially has an beneficial therapeutic effect in patients with vasospastic angina.The VIVA study aims to demonstrate the effect of Vericiguat on endothelial function and microvascular vasodilator responses, as well as its tolerability and safety in patients with vasospastic angina as the pathophysiological substrate of ANOCA.

Timeline

Start

2025-04-01

Primary completion

2026-06-01

Completion

2026-06-01

Publications

• Namba HF, de Jong EAM, Boerhout CKM, Mechroubi A, Nijkamp T, Damman P, Dimitriu-Leen AC, Meuwissen M, Heestermans TACM, den Haan MC, Beijk MAM, Vos NS, Escaned J, den Ruijter HM, Appelman Y, Eringa EC, Delewi R, Piek JJ, van de Hoef TP. Rationale and design of the vericiguat in vasospastic angina (ViVA) trial: A double-blind placebo-controlled randomized cross-over study. Am Heart J. 2026 Sep;299:107451. doi: 10.1016/j.ahj.2026.107451. Epub 2026 Apr 23.

Drugs

Indications