TY - JOUR
TI - Finerenone in patients with CKD and T2D with and without heart failure: A prespecified subgroup analysis of the FIDELIO-DKD trial.
AU - Filippatos, Gerasimos
AU - Pitt, Bertram
AU - Agarwal, Rajiv
AU - Farmakis, Dimitrios
AU - Ruilope, Luis M.
AU - Rossing, Peter
AU - Bauersachs, Johann
AU - Mentz, Robert J.
AU - Kolkhof, Peter
AU - Scott, Charlie
AU - Joseph, Amer
AU - Bakris, George L.
AU - Anker, Stefan D.
JO - European Journal of Heart Failure
PY - 2022
VL - null
TODO - null
SP - null
PB - 
SN - null
TODO - 10.1002/ejhf.2469
TODO - diabetes, heart failure, aldosterone, Chronic kidney disease, finerenone, mineralocorticoid receptor antagonists
TODO - 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.
ER -