Finerenone for Patients with Heart Failure and Preserved or Mildly Reduced Ejection Fraction

The nonsteroidal mineralocorticoid receptor antagonist improved this population's rate of worsening heart failure events in a randomized trial.

The value of mineralocorticoid receptor antagonists (MRAs) in treating heart failure (HF) with preserved left ventricular ejection fraction (HFpEF) has been controversial since the TOPCAT trial was published. Post hoc analysis suggested that without the subset of participants from the countries of Russia and Georgia (many apparently did not have HF or take the study drug), TOPCAT would have shown that spironolactone (a steroidal MRA) significantly reduced cardiovascular events in HFpEF. American College of Cardiology/American Heart Association HF guidelines include a weak class 2b recommendation for spironolactone in HFpEF. Now, the manufacturer-funded, randomized FINEARTS-HF trial (NCT04435626) has compared the nonsteroidal MRA finerenone …

Reviewing Author

Frederick A. Masoudi, MD, MSPH, MACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)

Frederick A. Masoudi, MD, MSPH, MACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)

Finerenone for Patients with Heart Failure and Preserved or Mildly Reduced Ejection Fraction

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Reviewing Author