Heart failure & cardiomyopathiesSecondary analysis
Finerenone Across the Spectrum of Kidney Risk in Heart Failure
- Secondary analysis of the FINEARTS-HF randomised trial
- prespecified analysis
Authors' conclusion
Finerenone appears to consistently improve clinical outcomes, HF-related health status, and albuminuria across a broad spectrum of kidney risk in patients with HF with mildly reduced or preserved ejection fraction.
Study context
- Population
- Patients with heart failure (HF) with mildly reduced or preserved EF (exclusions estimated glomerular filtration rate (eGFR) <25 mL/min/1.73 m² or serum potassium >5.0 mmol/L)97% with classifiable KDIGO risk
- Participants
- 5,797 patients
- Comparison
- Finerenone vs placebo by baseline KDIGO kidney risk category
- Lown = 2,022
- Moderaten = 1,688
- High/very highn = 2,087
- Primary endpoint
- CV death and total (first and recurrent) HF events, by baseline KDIGO risk category
- Follow-up
- Median 2.7 years
Primary result
As reported in the abstract
CV death and total HF events, finerenone vs placebo by kidney risk
Benefit of finerenone vs placebo consistent irrespective of baseline kidney risk category
Pinteraction = 0.24
Secondary outcomes
KCCQ-Total Symptom Score · 12 months
- Benefit of finerenone consistent irrespective of kidney risk category
- P for interaction = 0.36
Urine albumin-to-creatinine ratio · 6 months
- Greater reductions with finerenone in higher kidney risk
- P for interaction = 0.031
- No differences in eGFR slope
Composite kidney outcome, new-onset AF, vascular events
- Higher kidney risk associated with higher event rates
Safety
Safety events incl. hyperkalemia
- Risks with finerenone vs placebo not enhanced with higher kidney risk
Original publication
Finerenone Across the Spectrum of Kidney Risk in Heart Failure. JACC Heart Fail. Published 2 April 2025. doi:10.1016/j.jchf.2025.03.006
Summarised from the published abstract; every number is checked against it