Heart failure & cardiomyopathiesSecondary analysis
Finerenone and Atrial Fibrillation in Heart Failure
- Secondary analysis of the FINEARTS-HF randomised trial
- prespecified analyses
- 653 sites in 37 countries
Authors' conclusion
The efficacy of finerenone was consistent regardless of AF status. New-onset AF was associated with a substantially higher risk of subsequent outcomes.
Study context
- Population
- Adults aged ≥40 years with symptomatic heart failure (HF) and LVEF ≥40%known atrial fibrillation (AF) status at baseline
- Participants
- 5,984 adults
- Comparison
- Finerenone vs placebo by baseline AF status
- No AFn = 2,714reference
- Paroxysmal AFn = 1,384
- Persistent or permanent AFn = 1,886
- Primary endpoint
- Composite of:
- Total HF events
- CV death
Primary result
As reported in the abstract
Finerenone vs placebo on primary outcome, by baseline AF status
Finerenone vs PlaceboRelative risk (95% CI)
overall
0.84(0.74–0.95)
no AF
0.80(0.65–0.98)
paroxysmal AF
0.83(0.65–1.06)
persistent or permanent AF
0.85(0.69–1.05)
Further findings
Event rate, per 100 person-years
| Outcome | No AF | Paroxysmal AF | Persistent or permanent AF | Estimate | P value | |
|---|---|---|---|---|---|---|
| Primary outcome by AF type (unadjusted) — Paroxysmal AF vs No AF | 11.9 (95% CI 10.7–13.3) | 20.3 (95% CI 17.9–23.1) | 19.8 (95% CI 17.8–22.0) | RR 1.62 (95% CI 1.37–1.92) | ||
| Primary outcome by AF type (unadjusted) — Persistent or permanent AF vs No AF | RR 1.66 (95% CI 1.43–1.93) | |||||
| New-onset AF or AFL (prespecified exploratory) | subdistribution HR 0.77 (95% CI 0.57–1.04) | P = 0.09 | ||||
| Primary outcome after new-onset AF or AFL (adjusted) | rate ratio 3.65 (95% CI 2.57–5.18) | P < 0.001 | ||||
| 0.20.5125Ratio (log scale) |
- New-onset AF or AFL (prespecified exploratory) — New-onset AF or AFL incidence
- 6.5%
- Primary outcome by AF type (unadjusted): associations attenuated after adjustment for known prognostic variables
Original publication
Finerenone and Atrial Fibrillation in Heart Failure. JAMA Cardiol. Published 1 July 2025. doi:10.1001/jamacardio.2025.0848
Summarised from the published abstract; every number is checked against it