biostudies-literatureUnknown24(6)Filippatos G<h4>Aims</h4>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).<h4>Methods and results</h4>Patients with T2D and CKD (urine albumin-to-creatinine ratio ≥30-5000 mg/g and estimated glomerular filtration rate [eGFR] ≥25-<75 ml/min/1.73 m² ), 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. 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 HR 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 HR 0.83, 95% CI 0.73-0.94, respectively; interaction p = 0.83).<h4>Conclusion</h4>In FIDELIO-DKD, finerenone improved cardiorenal outcome in patients with CKD and T2D irrespective of baseline HF history.European journal of heart failure996-1005https://www.ebi.ac.uk/biostudies/studies/S-EPMC9541504biostudies-literatureFinerenone in patients with chronic kidney disease and type 2 diabetes with and without heart failure: a prespecified subgroup analysis of the FIDELIO-DKD trial.PMC9541504Mentz RJBakris GLAgarwal RFarmakis DScott CRossing PBauersachs JRuilope LMAnker SDFilippatos GFIDELIO-DKD InvestigatorsKolkhof PPitt BJoseph AfalseFinerenone in patients with chronic kidney disease and type 2 diabetes with and without heart failure: a prespecified subgroup analysis of the FIDELIO-DKD trial.<h4>Aims</h4>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).<h4>Methods and results</h4>Patients with T2D and CKD (urine albumin-to-creatinine ratio ≥30-5000 mg/g and estimated glomerular filtration rate [eGFR] ≥25-<75 ml/min/1.73 m² ), 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. 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 HR 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 HR 0.83, 95% CI 0.73-0.94, respectively; interaction p = 0.83).<h4>Conclusion</h4>In FIDELIO-DKD, finerenone improved cardiorenal outcome in patients with CKD and T2D irrespective of baseline HF history.2022-01-01T00:00:00Z2022 Jun2026-06-01T02:10:25.5Z2025-02-19T01:28:28.531ZS-EPMC95415043523920410.1002/ejhf.2469