Cardiometabolic & kidneyMeta-analysis
Sex differences in cardiovascular–kidney–metabolic syndrome: the FINE-HEART pooled analysis
- Prespecified pooled analysis of individual participant data from the FIDELIO-DKD, FIGARO-DKD and FINEARTS-HF randomised trials
- individual participant-level data
- adjusted Cox regression
Authors' conclusion
In this pooled analysis of individuals with advanced CKM syndrome, women had a higher burden of multimorbidity and were less likely to receive commonly indicated CKM therapies than men.
Study context
- Population
- CKD with T2DM (FIDELIO-DKD, FIGARO-DKD) or heart failure (HF) with mildly reduced or preserved EF (FINEARTS-HF)6,664 (35%) women
- Participants
- 18,991 participants
- Comparison
- Women vs men
- Womenn = 6,664
- Outcome
- First HF hospitalization, CV death, MACE, kidney composite outcome and all-cause death, women vs men
- Follow-up
- Median 2.9 years
Pooled result
As reported in the abstract
HF hospitalization or CV death; all-cause mortality
Women
4.8 per 100 patient-years
HF hospitalization or CV death
Men
3.9 per 100 patient-years
HF hospitalization or CV death
Women vs MenAdjusted hazard ratio (95% CI)P value
HF hospitalization or CV death
0.97(0.89–1.06)
P = 0.52all-cause mortality
0.83(0.76–0.91)
P < 0.001Further pooled results
Baseline age
Baseline urine albumin-to-creatinine ratio
Baseline cardiovascular-kidney-metabolic (CKM) stage and therapies
- Women more likely Stage 4 CKM syndrome but less likely to receive aspirin, statins, RAS inhibitors, SGLT2 inhibitors and GLP-1 receptor agonists
Finerenone treatment effect by sex (CV, kidney, mortality outcomes)
- No evidence of treatment heterogeneity by sex
- all Pinteraction >.05
- interaction P
Original publication
Sex differences in cardiovascular–kidney–metabolic syndrome: the FINE-HEART pooled analysis. Eur Heart J. Published 26 March 2026. doi:10.1093/eurheartj/ehag162
Summarised from the published abstract; every number is checked against it