Cardiometabolic & kidneyMeta-analysis
Anthropometric Measures, Cardiovascular Outcomes, and Treatment Effects of Finerenone in Cardiovascular-Kidney-Metabolic Disease
- Prespecified participant-level pooled analysis of the FIDELIO-DKD, FIGARO-DKD and FINEARTS-HF randomised trials (FINE-HEART)
Authors' conclusion
Finerenone consistently reduced adverse cardiovascular outcomes across a wide range of adiposity.
Study context
- Population
- Persons with cardiovascular-kidney-metabolic (cardiovascular, kidney, and metabolic (CKM)) conditionswith data for all anthropometrics
- Participants
- 18,759 persons
- Comparison
- Finerenone vs placebo, by adiposity-related anthropometrics
- Outcome
- CV outcomes and treatment effects of finerenone by baseline BMI, waist circumference, waist-height ratio and waist-hip ratio
Pooled result
As reported in the abstract
- Body mass index (BMI) ≥30 kg/m²
- 52%
- Any excess adiposity
- 98%
- Increased abdominal adiposity among those with BMI <30 kg/m²
- 95%
- Elevated BMI and waist-height ratio (WHtR) vs elevated BMI or WHtR alone: higher rate of CV death or heart failure (HF) hospitalization
- P < 0.001
- Finerenone benefit on CV death or HF hospitalization consistent regardless of baseline BMI
- Pinteraction = 0.27
- Finerenone benefit on CV death or HF hospitalization consistent regardless of baseline WHtR
- Pinteraction = 0.26
Safety
Serious adverse events
- Less common with finerenone vs placebo, regardless of baseline BMI category
- P for interaction = 0.08
Original publication
Anthropometric Measures, Cardiovascular Outcomes, and Treatment Effects of Finerenone in Cardiovascular-Kidney-Metabolic Disease. J Am Coll Cardiol. Published 27 August 2025. doi:10.1016/j.jacc.2025.08.039
Summarised from the published abstract; every number is checked against it