Heart failure & cardiomyopathiesSecondary analysis

Finerenone According to Insulin Resistance in Heart Failure: Insights from the FINEARTS-HF Trial

Eur J Heart FailPublished

  • Secondary analysis of the FINEARTS-HF randomised trial
  • exploratory analysis

Authors' 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

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/min vs 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

Finerenone safety profile by eGDR category

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:10.1002/ejhf.70034

Summarised from the published abstract; every number is checked against it