Τίτλος:
Finerenone in patients with CKD and T2D with and without heart failure: A prespecified subgroup analysis of the FIDELIO-DKD trial.
Περίληψη:
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.
Συγγραφείς:
Filippatos, Gerasimos
Pitt, Bertram
Agarwal, Rajiv
Farmakis, Dimitrios
Ruilope, Luis M.
Rossing, Peter
Bauersachs, Johann
Mentz, Robert J.
Kolkhof, Peter
Scott, Charlie
Joseph, Amer
Bakris, George L.
Anker, Stefan D.
Περιοδικό:
European Journal of Heart Failure
Λέξεις-κλειδιά:
diabetes, heart failure, aldosterone, Chronic kidney disease, finerenone, mineralocorticoid receptor antagonists
