In patients with post-myocardial infarction heart failure, 3 months of finerenone combined with guideline-directed medical therapy significantly improved left ventricular ejection fraction by 4% compared to baseline.
Cohort (n=67)
No
Does finerenone added to GDMT improve cardiac structure, function, and renal parameters in patients with post-myocardial infarction heart failure?
In a real-world cohort of post-MI heart failure patients, adding finerenone to GDMT for 3 months was associated with significant improvements in cardiac reverse remodeling, functional capacity, and NT-proBNP.
Mean Difference: 4 (95% CI 2–5)
Absolute Event Rate: 53% vs 49%
p-value: p=<0.001
Objective To evaluate the short-term impact of finerenone combined with guideline-directed medical therapy (GDMT) on cardiac structure, function, and renal parameters in Chinese patients with post-myocardial infarction heart failure in a real-world setting. Methods In this prospective observational cohort study, 67 patients received finerenone plus optimized GDMT for 3 months. Changes were assessed using echocardiography (measuring LVEF, GLS, left atrial strain and volume index), laboratory tests (NT-proBNP, serum potassium, renal function, urinary albumin-to-creatinine ratio UACR), and functional assessments (6-min walk test, Minnesota Living with Heart Failure Questionnaire). Results Treatment significantly improved cardiac function and structure. LVEF increased from 49 (2)% to 53 (2)% (P 0.001), GLS improved from 14 (1)% to 16 (1)% (P 0.001), and left atrial reservoir strain increased from 27 (2)% to 32 (2)% (P 0.001). Structural reverse remodeling was evidenced by reduced left ventricular end-diastolic diameter (54.85 1.08 to 52.85 0.96 mm, P 0.001) and left atrial volume index (38.78 2.69 to 36.25 2.61 mL/m 2 , P 0.001). Concurrently, a significant reduction in UACR was observed from 3.41 ± 1.52 mg/g to 2.76 ± 0.90 mg/g (P 0.001). Clinically, NT-proBNP decreased from 1,249 ± 1,251 to 431 ± 319 pg/mL (P 0.001), 6-min walk distance increased by 41.11 m (P 0.001), and quality of life scores improved (a reduction of 11.59 points, P 0.001). Serum potassium and renal function (serum creatinine) remained stable. Conclusion In this real-world cohort of 67 post-myocardial infarction heart failure patients, adding finerenone to GDMT for 3 months was associated with significant improvements in cardiac structure and function, a reduction in UACR, and better functional capacity and quality of life. Nevertheless, due to the single-arm design, these findings are exploratory and hypothesis-generating.
Zhao et al. (Fri,) conducted a cohort in Post-myocardial infarction heart failure (n=67). Finerenone plus guideline-directed medical therapy vs. Baseline (pre-treatment) was evaluated on Change in left ventricular ejection fraction (LVEF) at 3 months (MD 4%, 95% CI 2-5, p=<0.001). In patients with post-myocardial infarction heart failure, 3 months of finerenone combined with guideline-directed medical therapy significantly improved left ventricular ejection fraction by 4% compared to baseline.