Nonsteroidal Versus Steroidal Mineralocorticoid Receptor Antagonists in Heart Failure: Real-World Evidence From a Multicenter Cohort Study.

ABSTRACT:

Background

Mineralocorticoid receptor antagonists (MRAs) reduce mortality and hospitalization in patients with heart failure (HF). Finerenone, a selective nonsteroidal MRA, has recently demonstrated clinical benefits in patients with HF. However, real-world evidence comparing nonsteroidal and steroidal MRAs in HF is lacking.

Methods

We conducted a retrospective, propensity score-matched cohort study using the TriNetX database. Adult patients diagnosed with HF from January 2021 to February 2025 who initiated nonsteroidal or a steroidal MRA were included. The primary outcome was a composite of all-cause mortality, all-cause hospitalization, and worsening HF at 1 year. Secondary outcomes included each component individually and safety events. Subgroup and sensitivity analyses w

SUBMITTER: Wu JY 

PROVIDER: S-EPMC12684779 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature