Heart failure & cardiomyopathies
Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction: Prespecified Analysis of FINEARTS-HF
Authors' conclusion
In patients with HF with mildly reduced/preserved ejection fraction, the beneficial effects of finerenone on clinical events and symptoms were consistent, irrespective of BMI at baseline, possibly with a greater effect on the primary outcome in patients with higher BMI.
Study context
- Population
- Heart failure (HF), NYHA II–IV, LVEF ≥40%, structural heart disease and elevated natriuretic peptides; Body mass index (BMI) by WHO categoriesBMI available for 5,988
- Participants
- 6,001 participants
- Comparison
- Finerenone vs placebo by baseline BMI category
- Primary endpoint
- CV death and total worsening HF events
Methodological detailssubgroup analysis by baseline BMI
- Subgroup analysis by baseline BMI
Primary result
As reported in the abstract
CV death and total worsening HF events, finerenone vs placebo by baseline BMI
Finerenone vs PlaceboRate ratio (95% CI)
Underweight/normal weight (<25.0 kg/m²; n = 1,306)
0.80(0.62–1.04)
Overweight (25.0-29.9 kg/m²; n = 1,990)
0.91(0.72–1.15)
Obesity class I (30.0-34.9 kg/m²; n = 1,546)
0.92(0.72–1.19)
Obesity class II-III
0.67(0.50–0.89)
- Effect did not vary by baseline BMI category
- P for interaction = 0.32
- BMI as continuous variable: greater benefit with higher BMI
- P for interaction = 0.005
Further findings
| Outcome | Unadjusted rate ratio (95% CI) | |
|---|---|---|
| Primary outcome risk by BMI category (unadjusted, vs underweight/normal weight) — Overweight vs Underweight/normal weight | 0.96 (0.81–1.15) | |
| Primary outcome risk by BMI category (unadjusted, vs underweight/normal weight) — Obesity class I vs Underweight/normal weight | 1.04 (0.86–1.26) | |
| Primary outcome risk by BMI category (unadjusted, vs underweight/normal weight) — Obesity class II-III vs Underweight/normal weight | 1.26 (1.03–1.54) | |
| 0.512Unadjusted rate ratio (log scale) |
Total worsening HF events by BMI
- Similar pattern to primary outcome
CV death, all-cause death, KCCQ improvement by BMI
- Consistent effects across baseline BMI
Original publication
Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction: Prespecified Analysis of FINEARTS-HF. J Am Coll Cardiol. Published 10 December 2024. doi:10.
Summarised from the published abstract; every number is checked against it