The Role of Vericiguat in Early Phases of Anterior Myocardial Infarction: A Potential Game-Changer?

Abstract

Anterior myocardial infarction is a critical condition with significant implications for cardiac function and patient prognosis. Despite advancements in reperfusion therapies, optimizing recovery during the early phases of myocardial infarction remains challenging. Anterior myocardial infarction can lead to substantial long-term effects on a patient's health due to extensive damage to the heart muscle, particularly the left ventricle, impacting both quality of life and overall prognosis. Vericiguat, a soluble guanylate cyclase stimulator, has shown promise in heart failure, but its role in early anterior myocardial infarction has not yet been fully explored. By enhancing soluble guanylate cyclase activity, vericiguat may increase cyclic guanosine monophosphate production, leading to vasodilation, inhibition of platelet aggregation, and potential cardioprotective effects. Currently, treatment options for anterior myocardial infarction primarily focus on reperfusion strategies and managing complications. However, there is a critical need for adjunctive therapies that specifically target the pathophysiological changes occurring in the early phases of myocardial infarction. Vericiguat's mechanism of action offers a novel approach to improving vascular function and myocardial health, potentially contributing to innovative treatment strategies that could transform the care and prognosis of patients with anterior myocardial infarction.

Keywords: anterior myocardial infarction; cardioprotection; cyclic guanosine monophosphate (cGMP); nitric oxide (NO); vericiguat.

Figure 1

Coronary angiography performed during anterior STEMI, showing thrombotic occlusion of the ostial LAD.

Figure 2

NO-sGC-cGMP pathway, highlighting vericiguat’s role in stimulating sGC to increase cGMP production. This leads to vasodilation and reduced platelet aggregation, offering therapeutic benefits in myocardial infarction.