Heart failure & cardiomyopathiesSecondary analysis
Finerenone and Outpatient Worsening Heart Failure With Mildly Reduced or Preserved Ejection Fraction
- Secondary analysis of the FINEARTS-HF randomised trial
- prespecified
- multicentre
- global
Authors' conclusion
Outpatient worsening HF events requiring oral diuretic intensification were common, associated with poor prognosis, and reduced by finerenone in patients with HF with mildly reduced or preserved ejection fraction.
Study context
- Population
- Patients with heart failure (HF) and EF of 40% or greater (mildly reduced or preserved EF)
- Participants
- 6,001 patients
- Comparison
- Finerenone vs placebo
- Primary endpoint
- Outpatient oral diuretic intensification (initiation of loop or thiazide diuretic or increase in loop diuretic dosage), alone or in an extended composite with CV death, HF hospitalization and urgent HF visit
Primary result
As reported in the abstract
Finerenone vs PlaceboHazard ratio (95% CI)P value
outpatient oral diuretic intensification alone
0.89(0.80–0.98)
P = 0.02extended composite (oral diuretic intensification, CV death, HF hospitalization, urgent HF visit)
0.85(0.78–0.92)
P < 0.001Further findings
All-cause death rate after first worsening HF event, by type
per 100 patient-years
- After HF hospitalization (n = 664)
- 27.7 (95% CI, 24.3-31.5)
- After urgent HF visit (n = 87)
- 13.6 (95% CI, 8.8-21.1)
- After outpatient oral diuretic intensification (n = 1250)
- 11.6 (95% CI, 10.2-13.1)
- Without worsening HF
- 4.5 (95% CI, 4.2-4.9)
Patients with events when oral diuretic intensification added to primary outcome
- Primary outcome → extended composite
- 1343 to 2238
Original publication
Finerenone and Outpatient Worsening Heart Failure With Mildly Reduced or Preserved Ejection Fraction. JAMA Cardiol. Published 26 February 2025. doi:10.1001/jamacardio.2025.0016
Summarised from the published abstract; every number is checked against it