Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction
| Main Author: | |
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| Publication Date: | 2025 |
| Other Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Article |
| Language: | eng |
| Source: | Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) |
| Download full: | http://hdl.handle.net/10362/177489 |
Summary: | Publisher Copyright: © 2025 The Authors |
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Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection FractionPrespecified Analysis of FINEARTS-HFbody mass indexheart failure with preserved ejection fractionmineralocorticoid receptor antagonistobesitywaist-to-height ratioCardiology and Cardiovascular MedicineSDG 3 - Good Health and Well-beingPublisher Copyright: © 2025 The AuthorsBackground: Obesity is associated with excessive adipocyte-derived aldosterone secretion, independent of the classical renin-angiotensin-aldosterone cascade, and mineralocorticoid receptor antagonists may be more effective in patients with heart failure (HF) and obesity. Objectives: This study sought to examine the effects of the nonsteroidal mineralocorticoid receptor antagonist finerenone compared with placebo, according to body mass index (BMI) in FINEARTS-HF (FINerenone trial to investigate Efficacy and sAfety superioR to placebo in paTientS with Heart Failure). Methods: A total of 6,001 patients with HF with NYHA functional class II, III, and IV, a left ventricular ejection fraction of ≥40%, evidence of structural heart disease, and elevated natriuretic peptide levels were randomized to finerenone or placebo. BMI (kg/m2) was examined using World Health Organization categories, namely, underweight/normal weight (<25.0 kg/m2; n = 1,306); overweight (25.0-29.9 kg/m2; n = 1,990); obesity class I (30.0-34.9 kg/m2; n = 1,546); obesity class II (35.0-39.9 kg/m2; n = 751); and obesity class III (≥40 kg/m2; n = 395). The primary outcome was cardiovascular death and total worsening HF events. Results: Data on baseline BMI were available for 5,988 patients (median: 29.2 kg/m2; Q1-Q3: 25.5-33.6 kg/m2). Compared with patients who were underweight/normal weight, those with obesity class II or III had a higher risk of the primary outcome (underweight/normal weight, reference; overweight, unadjusted rate ratio: 0.96 [95% CI: 0.81-1.15]; obesity class I: 1.04 [95% CI: 0.86-1.26]; obesity class II-III: 1.26 [95% CI: 1.03-1.54]). The effect of finerenone on the primary outcome did not vary by baseline BMI (underweight/normal weight, rate ratio: 0.80 [95% CI: 0.62-1.04]; overweight: 0.91 [95% CI: 0.72-1.15]; obesity class I: 0.92 [95% CI: 0.72-1.19]; obesity class II-III: 0.67 [95% CI: 0.50-0.89]; Pinteraction = 0.32). However, when BMI was examined as a continuous variable, the beneficial effect of finerenone seemed to be greater in those with a higher BMI (Pinteraction = 0.005). A similar pattern was observed for total worsening HF events. Consistent effects across baseline BMI were observed for cardiovascular and all-cause death and improvement in the Kansas City Cardiomyopathy Questionnaire scores. Conclusions: In patients with HF with mildly reduced/preserved ejection fraction, the beneficial effects of finerenone on clinical events and symptoms were consistent, irrespective of BMI at baseline, possibly with a greater effect on the primary outcome in patients with higher BMI.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNButt, Jawad H.Henderson, Alasdair D.Jhund, Pardeep S.Claggett, Brian L.Desai, Akshay S.Lay-Flurrie, JamesViswanathan, PrabhakarLage, AndreaScheerer, Markus F.Lam, Carolyn S.P.Senni, MicheleShah, Sanjiv J.Voors, Adriaan A.Bauersachs, JohannFonseca, CândidaKosiborod, Mikhail N.Linssen, Gerard C.M.Petrie, Mark C.Schou, MortenVerma, SubodhZannad, FaiezPitt, BertramVaduganathan, MuthiahSolomon, Scott D.McMurray, John J.V.2025-01-15T21:24:46Z2025-01-212025-01-21T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article16application/pdfhttp://hdl.handle.net/10362/177489eng0735-1097PURE: 106396278https://doi.org/10.1016/j.jacc.2024.10.111info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2025-01-20T01:38:42Zoai:run.unl.pt:10362/177489Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T19:40:29.395242Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse |
| dc.title.none.fl_str_mv |
Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction Prespecified Analysis of FINEARTS-HF |
| title |
Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction |
| spellingShingle |
Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction Butt, Jawad H. body mass index heart failure with preserved ejection fraction mineralocorticoid receptor antagonist obesity waist-to-height ratio Cardiology and Cardiovascular Medicine SDG 3 - Good Health and Well-being |
| title_short |
Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction |
| title_full |
Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction |
| title_fullStr |
Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction |
| title_full_unstemmed |
Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction |
| title_sort |
Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction |
| author |
Butt, Jawad H. |
| author_facet |
Butt, Jawad H. Henderson, Alasdair D. Jhund, Pardeep S. Claggett, Brian L. Desai, Akshay S. Lay-Flurrie, James Viswanathan, Prabhakar Lage, Andrea Scheerer, Markus F. Lam, Carolyn S.P. Senni, Michele Shah, Sanjiv J. Voors, Adriaan A. Bauersachs, Johann Fonseca, Cândida Kosiborod, Mikhail N. Linssen, Gerard C.M. Petrie, Mark C. Schou, Morten Verma, Subodh Zannad, Faiez Pitt, Bertram Vaduganathan, Muthiah Solomon, Scott D. McMurray, John J.V. |
| author_role |
author |
| author2 |
Henderson, Alasdair D. Jhund, Pardeep S. Claggett, Brian L. Desai, Akshay S. Lay-Flurrie, James Viswanathan, Prabhakar Lage, Andrea Scheerer, Markus F. Lam, Carolyn S.P. Senni, Michele Shah, Sanjiv J. Voors, Adriaan A. Bauersachs, Johann Fonseca, Cândida Kosiborod, Mikhail N. Linssen, Gerard C.M. Petrie, Mark C. Schou, Morten Verma, Subodh Zannad, Faiez Pitt, Bertram Vaduganathan, Muthiah Solomon, Scott D. McMurray, John J.V. |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) RUN |
| dc.contributor.author.fl_str_mv |
Butt, Jawad H. Henderson, Alasdair D. Jhund, Pardeep S. Claggett, Brian L. Desai, Akshay S. Lay-Flurrie, James Viswanathan, Prabhakar Lage, Andrea Scheerer, Markus F. Lam, Carolyn S.P. Senni, Michele Shah, Sanjiv J. Voors, Adriaan A. Bauersachs, Johann Fonseca, Cândida Kosiborod, Mikhail N. Linssen, Gerard C.M. Petrie, Mark C. Schou, Morten Verma, Subodh Zannad, Faiez Pitt, Bertram Vaduganathan, Muthiah Solomon, Scott D. McMurray, John J.V. |
| dc.subject.por.fl_str_mv |
body mass index heart failure with preserved ejection fraction mineralocorticoid receptor antagonist obesity waist-to-height ratio Cardiology and Cardiovascular Medicine SDG 3 - Good Health and Well-being |
| topic |
body mass index heart failure with preserved ejection fraction mineralocorticoid receptor antagonist obesity waist-to-height ratio Cardiology and Cardiovascular Medicine SDG 3 - Good Health and Well-being |
| description |
Publisher Copyright: © 2025 The Authors |
| publishDate |
2025 |
| dc.date.none.fl_str_mv |
2025-01-15T21:24:46Z 2025-01-21 2025-01-21T00:00:00Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://hdl.handle.net/10362/177489 |
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http://hdl.handle.net/10362/177489 |
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eng |
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eng |
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0735-1097 PURE: 106396278 https://doi.org/10.1016/j.jacc.2024.10.111 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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