Heart failure & cardiomyopathies
Finerenone According to Insulin Resistance in Heart Failure: Insights from the FINEARTS-HF Trial
Primary result · CV death and total HF eventsResult — go to the resultAdjusted relative risk 1.63 95% CI 1.41–1.87Authors' conclusion
The eGDR, a validated measure of insulin resistance, was associated with a wide range of cardiovascular, kidney, and metabolic outcomes in patients with HF, including among those without diabetes. Finerenone reduced risk of cardiovascular outcomes and new-onset diabetes, irrespective of baseline insulin resistance.
Study context
- Population
- Patients with heart failure (HF) in FINEARTS-HF with calculable baseline estimated glucose disposal rate (eGDR)98% with calculable eGDR
- Participants
- 5,851 patients
- Comparison
- eGDR <5.1 vs ≥5.1 mg/kg/min; finerenone effect by eGDR category
- Primary endpoint
- CV death and total HF events
Methodological detailsexploratory analysis
- Exploratory analysis
Primary result
As reported in the abstract
Adjusted relative risk
1.63
95% CI 1.41–1.87
P < 0.001
eGDR <5.1 mg/kg/minvs eGDR ≥5.1 mg/kg/min
aRR 1.63 (95% CI 1.41–1.87); P < 0.001
Further findings
CV death and total HF events, by diabetes status (subgroup)
- Lower vs higher eGDR, with diabetes: aRR
- 1.72 (1.40-2.12) (95% CI)
- Lower vs higher eGDR, without diabetes: aRR
- 1.34 (1.07-1.68) (95% CI)
- Interaction P=0.06
Vascular events, kidney outcomes, new-onset diabetes, all-cause death
- Lower baseline eGDR associated with higher rates
Finerenone treatment effect by baseline eGDR category
- Benefit on CV death and total HF events consistent irrespective of eGDR
- P for interaction = 0.64
- Benefit on new-onset diabetes consistent irrespective of eGDR
- P for interaction = 0.36
Safety
- Baseline eGDR category did not modify the safety profile of finerenone
Original publication
Finerenone According to Insulin Resistance in Heart Failure: Insights from the FINEARTS-HF Trial. Eur J Heart Fail. Published 8 September 2025. doi:10.
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