Key result
Add-on finerenone linked to ~67% NT-proBNP reduction at 12 months in heart failure patients.
Why the study?
Finerenone is a highly selective nonsteroidal mineralocorticoid receptor antagonist, but data on its longitudinal clinical changes and safety outcomes in patients with HF in real-world clinical practice remain limited.
Does add-on finerenone improve cardiac structure, diastolic function, NT-proBNP levels, and NYHA functional class while maintaining safety in real-world Chinese patients with heart failure?
Observational (n=73)
Open-label
No
Does add-on finerenone improve cardiac structure, diastolic function, NT-proBNP levels, and NYHA functional class while maintaining safety in real-world Chinese patients with heart failure?
This single-center real-world observational study demonstrates that add-on finerenone is well tolerated with zero adverse-event discontinuations and is associated with favorable 12-month improvements in NT-proBNP, NYHA class, and cardiac diastolic function across HFrEF, HFmrEF, and HFpEF subgroups in Chinese patients.
Supports biomarker and diastolic improvements with finerenone add-on in real-world HF; extends trial data but leaves open randomized confirmation.
Objective Finerenone is a highly selective nonsteroidal mineralocorticoid receptor antagonist, but data on its use in patients with heart failure (HF) in real-world clinical practice remain limited. This study evaluated longitudinal clinical changes and safety outcomes observed during finerenone treatment in patients with HF. Methods This single-center, retrospective observational study included consecutive patients diagnosed with HF and treated with add-on finerenone between August 2023 and May 2024 at Tongji Hospital, Shanghai, China. All patients received finerenone add-on to standard treatment. Subgroup analyses were performed in patients with HF with preserved ejection fraction (HFpEF), HF with mildly reduced ejection fraction (HFmrEF), and HF with reduced ejection fraction (HFrEF). Adverse events were recorded, including HF readmission, outpatient visits for acute HF, and diuretic dosage escalation. Laboratory and cardiac function markers were also collected. Results Seventy-three patients were included. Favorable longitudinal changes were observed in cardiac structure, diastolic function, biomarker levels, and symptom status during follow-up. Left atrial diameter decreased from 50 to 48 mm, the E/e’ ratio decreased from 10.65 to 8.20, and NT-proBNP decreased by 67.47% at 12 months ( P < 0.001). NYHA functional class distribution also shifted toward lower symptom burden over time, and LVEF showed a modest increase. No patients discontinued finerenone because of adverse events. Conclusion In real-world clinical practice, finerenone was associated with a favorable clinical and safety profile in patients with HF, with profiles similar across the HFrEF, HFmrEF, and HFpEF subgroups. Future larger-sample, multicenter randomized controlled trials are warranted to validate these observations.
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Zhao et al. (2026) conducted an observational in Heart failure (n=73). Finerenone was evaluated on Percentage change in NT-proBNP levels from baseline to 12 months (p=<0.001). Finerenone add-on therapy in heart failure patients was associated with a 67.47% reduction in NT-proBNP and decreased E/e' from 10.65 to 8.20 at 12 months (P < 0.001) with zero discontinuations.
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