{"id":"09e8cb114416","type":"article","url":"https://hartvaat.nl/2025/01/21/finearts-hf-finerenon-bij-recent-verslechterend-hartfalen/","title":"FINEARTS-HF: finerenon bij recent verslechterend hartfalen","title_en":"Finerenone in Patients With a Recent Worsening Heart Failure Event: The FINEARTS-HF Trial.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":["acuut-hartfalen","finearts-hf","hfmref","hfref"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2024.09.004","source_url":"https://doi.org/10.1016/j.jacc.2024.09.004","authors":["Akshay S Desai","Muthiah Vaduganathan","Brian L Claggett","Ian J Kulac","Pardeep S Jhund","Jonathan Cunningham","Maria Borentain","James Lay-Flurrie","Prabhakar Viswanathan","Katja Rohwedder","Flaviana Amarante","Carolyn S P Lam","Michele Senni","Sanjiv J Shah","Adriaan A Voors","Faiez Zannad","Bertram Pitt","Mikhail Kosiborod","John J V McMurray","Scott D Solomon"],"significance":7,"published":"2025-01-21","source_date":"2025-01-21","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/betablokkers-bij-hartfalen/","https://hartvaat.nl/kennis/hartfalen/vericiguat-bij-hartfalen/"],"congress":"","summary_en":"This FINEARTS-HF subanalysis confirmed that finerenone is effective in patients with recent worsening heart failure events, supporting its use in the higher-acuity HFpEF population at greatest risk of recurrence.","created":"2026-07-03T10:31:26Z","updated":"2026-07-03T18:39:14Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Subanalyse van FINEARTS-HF toonde dat finerenon ook effectief is bij patiënten met recent verslechterend hartfalen. Het voordeel was het grootst bij hoger risico, wat vroege start na decompensatie ondersteunt.","abstract_original":"BACKGROUND: Patients with heart failure (HF) and a recent worsening heart failure (WHF) event are known to be at high risk of recurrent hospitalization and death, regardless of ejection fraction. OBJECTIVES: This study examined the efficacy and safety of the nonsteroidal mineralocorticoid receptor antagonist (MRA) finerenone in relation to the recency of a WHF event. METHODS: FINEARTS-HF (FINerenone trial to investigate Efficacy and sAfety superioR to placebo in paTientS with Heart Failure) was a randomized, double-blind, placebo-controlled trial of finerenone in patients with HF and left ventricular ejection fraction ≥40%. In this prespecified analysis, we assessed the risk of cardiovascular (CV) events and response to finerenone vs placebo in relation to the time from WHF to randomization (during or within 7 days, 7 days to 3 months, >3 months, or no prior WHF). The primary outcome was a composite of total (first and recurrent) WHF events and CV death, analyzed using a proportional rates method. RESULTS: Of 6,001 patients validly randomized to finerenone or placebo, 1,219 (20.3%) were enrolled during (749 [12.5%]) or within 7 days (470 [7.8%]), 2,028 (33.8%) between 7 days and 3 months, and 937 (15.6%) >3 months from a WHF event; 1,817 (30.3%) had no prior history of WHF. Rates of the primary composite outcome varied inversely with time since WHF, with >2-fold higher risk in those enrolled during or within 7 days of WHF compared with those enrolled >3 months from WHF or without prior WHF (risk ratio [RR]: 2.13; 95% CI: 1.82-2.55). Compared to placebo, finerenone appeared to lower the risk of the primary composite to a greater extent in those enrolled within 7 days of WHF (RR: 0.74; 95% CI: 0.57-0.95) or between 7 days and 3 months of WHF (RR: 0.79; 95% CI: 0.64-0.97) than in those >3 months from WHF or without prior WHF (RR: 0.99; 95% CI: 0.81-1.21); however, no definitive treatment-by-time interaction could be confirmed (P = 0.07). Greater absolute risk reductions with finerenone were accordingly seen in those with recent WHF (Ptrend = 0.011). The risk of adverse events including hyperkalemia and worsening renal function among patients assigned to finerenone was not increased in those with recent WHF. CONCLUSIONS: Compared with those without recent WHF, patients with HF and mildly reduced or preserved ejection fraction who have experienced a recent WHF event are at higher risk for recurrent HF events and CV death; a possible signal of enhanced absolute treatment benefit with finerenone in this population requires further confirmation in future studies. (Study to Evaluate the Efficacy [Effect on Disease] and Safety of Finerenone on Morbidity [Events Indicating Disease Worsening] & Mortality [Death Rate] in Participants With Heart Failure and Left Ventricular Ejection Fraction [Proportion of Blood Expelled Per Heart Stroke] Greater or Equal to 40% [FINEARTS-HF], NCT04435626; A study to gather information on the influence of study drug finerenone on the number of deaths and hospitalizations in participants with heart failure EudraCT 2020-000306-29)."}