Key result
Finerenone consistently reduces major events across adiposity categories despite ~33% higher risk from combined obesity markers.
Why the study?
The association between different adiposity-related anthropometrics and cardiovascular outcomes in persons with cardiovascular, kidney, and metabolic conditions has not been rigorously explored.
Does finerenone reduce adverse cardiovascular outcomes in individuals with cardiovascular-kidney-metabolic conditions across different adiposity-related anthropometrics?
Meta-Analysis (n=18,759)
Double-blind
Randomized
Yes
Does finerenone reduce adverse cardiovascular outcomes in individuals with cardiovascular-kidney-metabolic conditions across different adiposity-related anthropometrics?
Finerenone consistently reduces adverse cardiovascular outcomes across a wide range of adiposity in patients with cardiovascular-kidney-metabolic disease.
Answers are grounded in this paper and cite their sources.
Finerenone benefit holds across adiposity strata in CVKM; extends trial data to anthropometric subgroups.
BACKGROUND: Obesity is a core pathophysiologic contributor to cardiovascular, kidney, and metabolic (CKM) conditions. However, the association between different adiposity-related anthropometrics and cardiovascular outcomes in persons with CKM conditions has not been rigorously explored. OBJECTIVES: In this study, the authors sought to examine cardiovascular outcomes and treatment effects of finerenone according to different adiposity-related anthropometrics. METHODS: In this prespecified participant-level pooled analysis of FIDELIO-DKD, FIGARO-DKD, and FINEARTS-HF (FINE-HEART), cardiovascular outcomes and treatment effects of finerenone according to baseline body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), and waist-hip ratio (WHR) were evaluated with the use of multivariable-adjusted Cox proportional hazards regression and Poisson regression. CONCLUSIONS: These findings suggest that assessment of anthropometrics capturing abdominal adiposity, in addition to BMI, may enhance obesity identification and risk stratification among individuals with CKM conditions. Finerenone consistently reduced adverse cardiovascular outcomes across a wide range of adiposity. (FINE-HEART: An Integrated Pooled Analysis of Finerenone Across 3 Phase III Trials of Heart Failure and Chronic Kidney Disease and Type 2 Diabetes; CRD42024570467).
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Ostrominski et al. (2025) conducted a meta-analysis in Cardiovascular-Kidney-Metabolic Disease (n=18,759). Elevated BMI (≥30 kg/m²) and waist-height ratio (≥0.6) vs. BMI <30 kg/m² and waist-height ratio <0.6 was evaluated on Cardiovascular death or heart failure hospitalization (HR 1.33, 95% CI 1.19-1.49, p=<0.001). In patients with cardiovascular-kidney-metabolic conditions, the combination of elevated BMI and waist-height ratio was associated with a 33% higher rate of cardiovascular death or heart failure hospitalization compared to neither being elevated, while finerenone consistently reduced these events across all adiposity categories.
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