Finerenone, Chronic Obstructive Pulmonary Disease, and Heart Failure with Mildly Reduced or Preserved Ejection Fraction: A Prespecified Analysis of the FINEARTS-HF Trial

AIMS: Chronic obstructive pulmonary disease (COPD) is associated with worse outcomes in heart failure (HF) with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF). A post hoc analysis of TOPCAT suggested that the effectiveness of the steroidal mineralocorticoid receptor antagonist (MRA), spironolactone, may be modified by pulmonary disease, with a greater benefit in patients with COPD/asthma. We examined the effects of the non-steroidal MRA, finerenone, compared to placebo, according to COPD status in a prespecified analysis of FINEARTS-HF. METHODS AND RESULTS: = 0.46). CONCLUSION: In patients with HFmrEF/HFpEF, the beneficial effects of finerenone on clinical events and symptoms were consistent, regardless of COPD status. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov ID NCT04435626.