{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:12:05Z","timestamp":1790957525684,"version":"4.1.0"},"reference-count":30,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:sec id=\"ab-hoi230027-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>It is currently unclear whether chronic kidney disease (CKD)\u2013associated cardiovascular risk in type 2 diabetes (T2D) is modifiable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi230027-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine whether cardiovascular risk can be modified with finerenone in patients with T2D and CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi230027-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>Incidence rates from Finerenone in Chronic Kidney Disease and Type 2 Diabetes: Combined FIDELIO-DKD and FIGARO-DKD Trial Programme Analysis (FIDELITY), a pooled analysis of 2 phase 3 trials (including patients with CKD and T2D randomly assigned to receive finerenone or placebo) were combined with National Health and Nutrition Examination Survey data to simulate the number of composite cardiovascular events that may be prevented per year with finerenone at a population level. Data were analyzed over 4 years of consecutive National Health and Nutrition Examination Survey data cycles (2015-2016 and 2017-2018).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi230027-7\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Incidence rates of cardiovascular events (composite of cardiovascular death, nonfatal stroke, nonfatal myocardial infarction, or hospitalization for heart failure) were estimated over a median of 3.0 years by estimated glomerular filtration rate (eGFR) and albuminuria categories. The outcome was analyzed using Cox proportional hazards models stratified by study, region, eGFR and albuminuria categories at screening, and cardiovascular disease history.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi230027-8\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This subanalysis included a total of 13\u202f026 participants (mean [SD] age, 64.8 [9.5] years; 9088 male [69.8%]). Lower eGFR and higher albuminuria were associated with higher incidences of cardiovascular events. For recipients in the placebo group with an eGFR of 90 or greater, incidence rates per 100 patient-years were 2.38 (95% CI, 1.03-4.29) in those with a urine albumin to creatinine ratio (UACR) less than 300 mg\/g and 3.78 (95% CI, 2.91-4.75) in those with UACR of 300 mg\/g or greater. In those with eGFR less than 30, incidence rates increased to 6.54 (95% CI, 4.19-9.40) vs 8.74 (95% CI, 6.78-10.93), respectively. In both continuous and categorical models, finerenone was associated with a reduction in composite cardiovascular risk (hazard ratio, 0.86; 95% CI, 0.78-0.95;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.002) irrespective of eGFR and UACR (\n                      <jats:italic>P<\/jats:italic>\n                      value for interaction\u2009=\u2009.66). In 6.4 million treatment-eligible individuals (95% CI, 5.4-7.4 million), 1 year of finerenone treatment was simulated to prevent 38\u202f359 cardiovascular events (95% CI, 31\u202f741-44\u202f852), including approximately 14\u202f000 hospitalizations for heart failure, with 66% (25\u202f357 of 38\u202f360) prevented in patients with eGFR of 60 or greater.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi230027-9\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Results of this subanalysis of the FIDELITY analysis suggest that CKD-associated composite cardiovascular risk may be modifiable with finerenone treatment in patients with T2D, those with eGFR of 25 or higher, and those with UACR of 30 mg\/g or greater. UACR screening to identify patients with T2D and albuminuria with eGFR of 60 or greater may provide significant opportunities for population benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamacardio.2023.1505","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T11:01:04Z","timestamp":1686740464000},"page":"732","source":"Crossref","is-referenced-by-count":37,"title":["Modifiability of Composite Cardiovascular Risk Associated With Chronic Kidney Disease in Type 2 Diabetes With Finerenone"],"prefix":"10.1001","volume":"8","author":[{"given":"Rajiv","family":"Agarwal","sequence":"first","affiliation":[{"name":"Richard L. 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis M.","family":"Ruilope","sequence":"additional","affiliation":[{"name":"Cardiorenal Translational Laboratory and Hypertension Unit, Institute of Research i+12, Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dia en Red Enfermedades Cardiovasculares (CIBER-CV), Hospital Universitario 12 de Octubre, Madrid, Spain"},{"name":"Faculty of Sport Sciences, European University of Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csaba P.","family":"Kovesdy","sequence":"additional","affiliation":[{"name":"Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee"},{"name":"Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Tuttle","sequence":"additional","affiliation":[{"name":"Providence Medical Research Center, Providence Health Care, Spokane, Washington"},{"name":"Division of Nephrology, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Wanner","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University Hospital of W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Bansilal","sequence":"additional","affiliation":[{"name":"US Medical Affairs, Bayer Corporation, Whippany, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Gebel","sequence":"additional","affiliation":[{"name":"Research and Development, Integrated Analysis Statistics, Bayer AG, Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amer","family":"Joseph","sequence":"additional","affiliation":[{"name":"Cardiology and Nephrology Clinical Development, Bayer AG, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Lawatscheck","sequence":"additional","affiliation":[{"name":"Clinical Research, Bayer AG, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George L.","family":"Bakris","sequence":"additional","affiliation":[{"name":"Department of Medicine, 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