@article{3203341,
    title = "Finerenone in patients with CKD and T2D with and without heart failure: A prespecified subgroup analysis of the FIDELIO-DKD trial.",
    author = "Filippatos, Gerasimos and Pitt, Bertram and Agarwal, Rajiv and Farmakis, Dimitrios and Ruilope, Luis M. and Rossing, Peter and Bauersachs, Johann and Mentz, Robert J. and Kolkhof, Peter and Scott, Charlie and Joseph, Amer and Bakris, George L. and Anker, Stefan D.",
    journal = "European Journal of Heart Failure",
    year = "2022",
    doi = "10.1002/ejhf.2469",
    keywords = "diabetes, heart failure, aldosterone, Chronic kidney disease, finerenone, mineralocorticoid receptor antagonists",
    abstract = "AIMS: This prespecified analysis of the FIDELIO-DKD trial compared the effects of finerenone, a selective, non-steroidal mineralocorticoid receptor antagonist, on  cardiorenal outcomes in patients with chronic kidney disease (CKD) and type 2  diabetes (T2D) by history of heart failure (HF). METHODS: Patients with T2D and CKD  (urine albumin-to-creatinine ratio ≥ 30-5000 mg/g and estimated glomerular  filtration rate (eGFR) ≥25-{\textless}75 mL/min/1.73 m(2) ), without symptomatic HF with  reduced ejection fraction (New York Heart Association II-IV) and treated with  optimized renin-angiotensin system blockade were randomized to finerenone or  placebo. The composite cardiovascular (CV) outcome (CV death, non-fatal myocardial  infarction, non-fatal stroke, or hospitalization for HF) and composite kidney  outcome (kidney failure, sustained ≥40\% decrease in eGFR from baseline, or renal  death) were analysed by investigator-reported medical history of HF. RESULTS: Of  5674 patients, 436 (7.7\%) had a history of HF. Over a median follow-up of 2.6 years,  the effect of finerenone compared with placebo on the composite CV outcome was  consistent in patients with and without a history of HF (hazard ratio [HR] 0.73 [95\%  confidence interval (CI) 0.50-1.06] and 0.90 [95\% CI 0.77-1.04], respectively;  interaction P = 0.33). The effect of finerenone on the composite kidney outcome did  not differ by history of HF (HR 0.79 [95\% CI 0.52-1.20] and 0.83 [95\% CI 0.73-0.94],  respectively; interaction P = 0.83). CONCLUSION: In FIDELIO-DKD, finerenone improved  cardiorenal outcome in patients with CKD and T2D irrespective of baseline HF  history. This article is protected by copyright. All rights reserved."
}