Finerenone Benefits in HF With Mildly Reduced or Preserved Ejection Fraction Regardless of Baseline Risk: JAMA
UK: A secondary analysis of the FINEARTS-HF randomized clinical trial evaluated the performance of the PREDICT-HFpEF model in estimating heart failure risk and its potential role in guiding finerenone therapy.
The study, published in JAMA Cardiology, demonstrated that patients with heart failure with mildly reduced (HFmrEF) or preserved ejection fraction (HFpEF) benefit from finerenone, regardless of baseline risk. The PREDICT-HFpEF models also performed well in calibration and discrimination, confirming their reliability.
For this purpose, the researchers conducted the FINEARTS-HF trial across 653 sites in 37 countries, enrolling adults aged 40 years and older with symptomatic heart failure and a left ventricular ejection fraction of 40% or greater. Participants were randomized between September 2020 and January 2023 to receive finerenone (titrated to 20 mg or 40 mg) or a placebo.
The study assessed the three PREDICT-HFpEF risk scores for cardiovascular death or heart failure hospitalization, cardiovascular death alone, and all-cause mortality. Predicted risk was compared with observed outcomes, and model performance was evaluated using the Harrell C statistic. The rates of predicted outcomes, including the composite of cardiovascular death and worsening heart failure events, were analyzed across risk quintiles, along with the effect of finerenone in different risk categories.
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