Finerenone in Heart Failure and Chronic Kidney Disease with Type 2 Diabetes: the FINE-HEART pooled analysis of cardiovascular, kidney, and mortality outcomes (2024)

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Abstract Access options Additional access options: Similar content being viewed by others A hierarchical kidney outcome using win statistics in patients with heart failure from the DAPA-HF and DELIVER trials Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trial Effects of renal denervation on kidney function in patients with chronic kidney disease: a systematic review and meta-analysis Author information Authors and Affiliations Corresponding author Supplementary information Supplementary Information Reporting Summary Rights and permissions About this article Cite this article References

Abstract

Cardiovascular-kidney-metabolic syndrome is an emerging entity that connects cardiovascular diseases, chronic kidney disease, and diabetes. The non-steroidal mineralocorticoid receptor antagonist, finerenone, has been studied in three prospective randomized clinical trials of patients with cardio-kidney-metabolic syndrome: FIDELIO-DKD, FIGARO-DKD, and FINEARTS-HF. In light of the strong epidemiological overlap and shared mechanistic drivers of clinical outcomes across cardio-kidney-metabolic syndrome, we summarize the efficacy and safety of finerenone on cardiovascular, kidney, and mortality outcomes in this prespecified participant-level pooled analysis. The three trials included 18,991 participants (mean age 67 ± 10 years; 35% women). During 2.9 years median follow-up, the primary outcome of cardiovascular death occurred in 421 (4.4%) assigned to finerenone and 471 (5.0%) assigned to placebo (HR 0.89; 95% CI 0.78-1.01; P = 0.076). Death from any cause occurred in 1,042 (11.0%) participants in the finerenone arm and 1,136 (12.0%) in the placebo arm (HR 0.91; 95% CI 0.84-0.99; P = 0.027). Finerenone further reduced the risk of HF hospitalization (HR 0.83; 95% CI 0.75-0.92; P < 0.001) and the composite kidney outcome (HR 0.80; 95% CI 0.72-0.90; P < 0.001). While this pooled analysis failed to demonstrate significant reductions in cardiovascular death, finerenone was associated with significantly lower deaths of any cause, cardiovascular events, and kidney outcomes. PROSPERO identifier: CRD42024570467

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Similar content being viewed by others

Finerenone in Heart Failure and Chronic Kidney Disease with Type 2 Diabetes: the FINE-HEART pooled analysis of cardiovascular, kidney, and mortality outcomes (1)

A hierarchical kidney outcome using win statistics in patients with heart failure from the DAPA-HF and DELIVER trials

Article Open access 06 May 2024

Finerenone in Heart Failure and Chronic Kidney Disease with Type 2 Diabetes: the FINE-HEART pooled analysis of cardiovascular, kidney, and mortality outcomes (2)

Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trial

Article Open access 25 May 2024

Finerenone in Heart Failure and Chronic Kidney Disease with Type 2 Diabetes: the FINE-HEART pooled analysis of cardiovascular, kidney, and mortality outcomes (3)

Effects of renal denervation on kidney function in patients with chronic kidney disease: a systematic review and meta-analysis

Article Open access 04 September 2023

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Authors and Affiliations

  1. Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

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    Muthiah Vaduganathan,Brian L. Claggett,Akshay S. Desai&Scott D. Solomon

  2. National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece

    Gerasimos Filippatos

  3. University of Glasgow, Glasgow, Scotland, UK

    Pardeep S. Jhund,Alasdair Henderson&John J. V. McMurray

  4. Bayer, Research & Development, Pharmaceuticals, Berlin, Germany

    Meike Brinker,Peter Kolkhof,Patrick Schloemer,James Lay-Flurrie&Prabhakar Viswanathan

  5. National Heart Centre Singapore & Duke-National University of Singapore, Singapore, Singapore

    Carolyn S. P. Lam

  6. University of Milano-Bicocca ASST Papa Giovanni XXIII Hospital, Bergamo, Italy

    Michele Senni

  7. Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Sanjiv J. Shah

  8. University of Groningen, Groningen, Netherlands

    Adriaan A. Voors

  9. University of Lorraine, Nancy, France

    Faiez Zannad

  10. Steno Diabetes Center Copenhagen, Herlev, Denmark and University of Copenhagen, Copenhagen, Denmark

    Peter Rossing

  11. Hospital 12 de Octubre, Madrid, Spain

    Luis M. Ruilope

  12. Charité University, Berlin, Germany

    Stefan D. Anker

  13. University of Michigan, Ann Arbor, Michigan, USA

    Bertram Pitt

  14. Indiana University School of Medicine, Indianapolis, Indiana, USA

    Rajiv Agarwal

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  1. Muthiah Vaduganathan

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Correspondence to Scott D. Solomon.

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Finerenone in Heart Failure and Chronic Kidney Disease with Type 2 Diabetes: the FINE-HEART pooled analysis of cardiovascular, kidney, and mortality outcomes (4)

Cite this article

Vaduganathan, M., Filippatos, G., Claggett, B.L. et al. Finerenone in Heart Failure and Chronic Kidney Disease with Type 2 Diabetes: the FINE-HEART pooled analysis of cardiovascular, kidney, and mortality outcomes. Nat Med (2024). https://doi.org/10.1038/s41591-024-03264-4

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  • DOI: https://doi.org/10.1038/s41591-024-03264-4

Finerenone in Heart Failure and Chronic Kidney Disease with Type 2 Diabetes: the FINE-HEART pooled analysis of cardiovascular, kidney, and mortality outcomes (2024)

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