The VICTORIA trial enrolled 5050 subjects (≥18 aa) with chronic HFrEF (NYHA functional classes II–IV) with reduced LVEF (defined as LVEF < 45% within 12 months before randomization) and a recent episode of worsening HF defined by symptoms of HF or signs of congestion that required hospitalization or outpatient administration of IV diuretics and an elevated natriuretic peptide level within 30 days before randomization (BNP ≥ 300 pg/mL or NT-proBNP ≥ 1000 pg/mL if in sinus rhythm; BNP ≥ 500 pg/mL or NT-proBNP ≥ 1600 pg/mL if in atrial fibrillation) (Table 1). This evidence concerns the gene NPPB and atrial fibrillation.