Key result
Finerenone reduces CV death and worsening HF events by ~16%.
Why the study?
An unprecedented volume of evidence since the 2021 ESC and 2022 AHA/ACC/HFSA guidelines has substantially expanded the HF therapeutic landscape across the entire EF spectrum.
This review synthesizes recent landmark trials that expand the therapeutic landscape for heart failure across all ejection fractions, highlighting new roles for SGLT2 inhibitors, non-steroidal MRAs, incretin therapies, and structural interventions.
Opens new treatment axis for HF with LVEF ≥40%; extends non-steroidal MRA benefit across EF spectrum.
The interval since the 2021 European Society of Cardiology (ESC) Guidelines and 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America (AHA/ACC/HFSA) Guidelines publications has witnessed an unprecedented volume of evidence that substantially expands the therapeutic landscape across the entire ejection fraction (EF) spectrum. Major developments include the emergence of non-steroidal mineralocorticoid receptor antagonists and incretin-based therapies for heart failure (HF) with mildly reduced and preserved EF, the validation of rapid guideline-directed medical therapy optimization strategies in acute HF, and new evidence supporting digitalis glycosides in HF patients with reduced EF. Device-based care has evolved with transcatheter edge-to-edge repair for valvular heart disease. These data are likely to reshape contemporary clinical practice.
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Liori et al. (2026) conducted a review in Heart Failure. Finerenone reduced the composite primary endpoint of cardiovascular death and total worsening heart failure events by 16%.
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