About Heart Failure
Approximately 63 million people live with heart failure worldwide. In heart failure, the ability of the heart to fill and empty is compromised, causing shortness of breath, fatigue, swelling in the legs, and difficulty with activities of daily living.
While many people with heart failure have severely compromised ability for the heart to pump (a reduced ejection fraction), about half of all people with heart failure have only mildly reduced or even preserved ejection fraction, yet have similar symptoms as with those with reduced ejection fraction. While therapies for heart failure with reduced ejection fraction have been available for some time, few therapies have been demonstrated to benefit patients with heart failure and mildly reduced or preserved ejection fraction.
What was FINEARTS-HF?
FINEARTS-HF was a randomized, placebo-controlled, double-blind international clinical outcomes trial comparing the non-steroidal MRA finerenone with placebo to reduce the risk of cardiovascular death or total worsening heart failure events in patients with heart failure with mildly reduced or preserved ejection fraction.
Patients were eligible if they had heart failure with LVEF > 40%, evidence of structural heart disease and elevated natriuretic peptides. Patients could be enrolled if ambulatory, hospitalized or recently hospitalized.
What did FINEARTS-HF show?
FINEARTS-HF showed that finerenone, a non-steroidal mineralocorticoid receptor antagonist (MRA), reduced a composite endpoint of cardiovascular death and total worsening heart failure events compared to placebo by 16% (Rate Ratio 0.84, 95% CI 0.74-0.95, p = 0.007), reduced total heart failure events by 18% (p = 0.006), and improved health status (KCCQ-TSS). The findings were consistent across all prespecified subgroups, including by ejection fraction and whether patients were taking SGLT2 inhibitors at baseline.
What do the FINEARTS-HF findings mean for patients?
These data are the first definitive data showing the benefit of an MRA in heart failure with mildly reduced or preserved ejection fraction, and support the use of finerenone in this patient population.