AnaCardio's €62.5M Series B Bets a Safer Inotrope Can Reopen Heart Failure

Sixty-two and a half million euros is not a large number by biotech standards. For AnaCardio, a small company in Stockholm, it is the money that decides whether an abandoned class of heart drugs gets a second life.

Heart failure with reduced ejection fraction is one of medicine's stubborn problems. The muscle cannot push enough blood forward, and the outlook after diagnosis is poor. The standard treatment is a stack of drugs that slow the decline — beta-blockers, ARNIs, MRAs, SGLT2 inhibitors — and none of them make the heart pump harder.

Drugs that do make it pump harder exist. They are called inotropes. Hospitals use them, and they shorten lives.

The class medicine quit

Inotropes work. Dobutamine and milrinone push a failing heart toward a better output within hours, and they have been in hospital formularies for decades. The trouble arrives later. They raise the risk of arrhythmia, drop blood pressure, and in several trials they increased mortality. The drugs keep patients alive through a crisis, then quietly work against them.

Levosimendan is the closest relative to AC01. It is a calcium sensitiser — it makes the muscle respond to the calcium it already has, rather than flooding it with more. That mechanism avoids some of the toxicity, and it is used across Europe. It is still given by infusion, in a hospital, to acute patients.

AC01 borrows the mechanism and changes the delivery. It is an oral ghrelin-receptor agonist that raises calcium sensitivity, taken as minitablets twice a day, and it was licensed from the Swiss group Helsinn in 2022. The pitch is a chronic drug, not a rescue drug: something a stable patient takes at home to keep the heart contracting.

That difference is the reason the round exists. A chronic oral therapy for heart failure would sit next to the existing pill stack, not compete with it.

The data confirm what we have seen across preclinical and clinical studies: AC01 improves cardiac function with a clearly differentiated safety profile.— Patrik Strömberg, chief executive, AnaCardio

What the trial showed, and what it did not

The evidence is the Phase 1b/2a GOAL-HF1 study, registered as NCT05642507: fifty-eight patients with reduced ejection fraction, randomised, double-blind, placebo-controlled, run across European heart-failure centres. It finished in October 2025 and was published in The Lancet on 25 June 2026.

The safety signal was clean. No serious adverse events linked to the drug, no deaths, no discontinuations. No tachycardia, no sustained arrhythmias, no ischaemia, no symptomatic hypotension. For a drug class defined by exactly those side effects, that is the headline.

The efficacy signal was directional. At the 3 mg dose, cardiac output rose 29.5% on day one and 22.0% by day 28, and left-ventricular ejection fraction gained 4.8 absolute points over four weeks, against 1.6 points on placebo — all on top of optimised guideline therapy.

Then the caveats. Fifty-eight patients is a signal, not a proof. The cohort was small, older and largely male, and the study was not powered to detect anything except safety and dose behaviour. The endpoints that matter — death, hospitalisation — were not measured at scale.

As we wrote in September, Novartis lowered Lp(a) in more than 8,000 patients and cardiovascular events did not move. A stronger pump is not the same thing as a longer life. AnaCardio's Phase 2b has to close that gap.

Who wrote the check

The round, announced on 30 September, was co-led by Novo Holdings and the Ljungström family office. The originator Helsinn came back in, alongside existing investors Pureos Bioventures, Sound Bioventures, Industrifonden, Flerie and LLD Nybohov Invest, and one new name, Innovestor Life Science.

Round structure. Source: AnaCardio, 30 September 2026

Two names carry more weight than the rest. Novo Holdings is the holding company behind Novo Nordisk, and its presence in a cardiovascular round is a statement about the therapeutic area, not just the company. The Ljungström family office is the vehicle of Fredrik Ljungström, an early and repeated backer who has followed AnaCardio across four previous financings.

The single clearest vote is Helsinn's. The company that invented the molecule and licensed it out is putting money back in at a higher price. Originators rarely do that for a mechanism they have stopped believing in.

The oral problem is the hard part

Most peptides and peptide-like molecules do not survive the stomach, and ghrelin is a peptide. AnaCardio's entire commercial claim rests on a small molecule that behaves like one and can be swallowed. The company reports dose-proportional pharmacokinetics and confirmed target engagement, which suggests the drug reaches what it is aimed at. Whether a patient absorbs enough of it, every day, for years, is a manufacturing and formulation question as much as a pharmacological one.

The competition is not another biotech with the same idea. It is the standard-of-care stack that already keeps these patients stable, and the devices — defibrillators, resynchronisation, pumps — that hospitals reach for when pills fail. A new oral drug has to earn a place in a regimen that is already crowded.

The company has the regulatory scaffolding to try. AnaCardio reports aligned scientific advice from both the FDA and the EMA on a development path for chronic heart failure, and holds a US patent covering AC01 into the 2040s.

What would have to be true for the €62.5 million to look cheap?

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