Vericiguat stimulates guanylate cyclase to increase cellular cGMP production. Interestingly, Viagra also increases cGMP but instead inhibits the phosphodiesterase enzyme that breaks it down. I am no heart failure expert, so I cannot chime in on cGMP therapies for heart failure. Apabetalone works through a totally different mechanism of action and does not involve cGMP modulation to my knowledge. cGMP modulation is completely different from BET inhibition.

Also, as far as I know apabetalone hasn't been used to treat patients with pre-existing heart failure; only found to reduce first incidence in BETonMACE. The Victoria trial was in patients with pre-existing heart failure.

BDAZ