Heart failure & cardiomyopathiesSecondary analysis
Finerenone in Heart Failure With Improved Ejection Fraction
- Secondary analysis of a randomised controlled trial
- prespecified analysis
Authors' conclusion
In this prespecified analysis of a randomized clinical trial, patients with HFimpEF remained at high risk of CV events, underscoring the need for continued management despite LVEF improvement. The treatment benefits of finerenone observed among the overall population of patients with HF with preserved EF were consistent among patients with HFimpEF.
Study context
- Population
- Patients with heart failure (HF), left ventricular ejection fraction (LVEF) ≥40%, NYHA class II–IV and elevated natriuretic peptides
- Participants
- 6,001 patients
- Comparison
- Finerenone vs placebo, by prior LVEF <40% vs LVEF consistently ≥40%
- HFimpEFn = 273
- Primary endpoint
- Composite of:
- CV death
- Total (first and recurrent) worsening HF events
- Follow-up
- Median 2.6 years
Primary result
CV death and worsening HF events, by prior LVEF
Relative risk
1.13
95% CI 0.85–1.49
P = 0.39
By group
HFimpEF
21.4 per 100 patient-years
LVEF consistently ≥40%
16.0 per 100 patient-years
HFimpEF vs LVEF consistently ≥40%
RR 1.13 (95% CI 0.85–1.49); P = 0.39
As reported in the abstract
Safety
Safety of finerenone by prior LVEF
- More hypotension with finerenone in HFimpEF; otherwise similar safety profile
Original publication
Finerenone in Heart Failure With Improved Ejection Fraction. JAMA Cardiol. Published 1 July 2025. doi:10.1001/jamacardio.2025.1101
Summarised from the published abstract; every number is checked against it