{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:52:24Z","timestamp":1793321544442,"version":"4.5.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,1,14]],"date-time":"2023-01-14T00:00:00Z","timestamp":1673654400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Bayer AG, Berlin, Germany"},{"name":"FIDELIO-DKD"},{"name":"FIGARO-DKD"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Finerenone reduces the risk of cardiovascular events in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D). We investigated the causes of mortality in the FIDELITY population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The FIDELITY prespecified pooled data analysis from FIDELIO-DKD and FIGARO-DKD excluded patients with heart failure and reduced ejection fraction. Outcomes included intention-to-treat and prespecified on-treatment analyses of the risk of all-cause and cardiovascular mortality. Of 13\u2009026 patients [mean age, 64.8 years; mean estimated glomerular filtration rate (eGFR), 57.6 mL\/min\/1.73 m2], 99.8% were on renin\u2013angiotensin system inhibitors. Finerenone reduced the incidence of all-cause and cardiovascular mortality vs. placebo (8.5% vs. 9.4% and 4.9% vs. 5.6%, respectively) and demonstrated significant on-treatment reductions [hazard ratio (HR), 0.82; 95% confidence interval (CI), 0.70\u20130.96; P\u00a0=\u00a00.014 and HR, 0.82; 95% CI, 0.67\u20130.99; P\u00a0=\u00a00.040, respectively]. Cardiovascular-related mortality was most common, and finerenone lowered the incidence of sudden cardiac death vs. placebo [1.3% (incidence rate 0.44\/100 patient-years) vs. 1.8% (0.58\/100 patient-years), respectively; HR, 0.75; 95% CI, 0.57\u20130.996; P\u00a0=\u00a00.046]. The effects of finerenone on mortality were similar across all Kidney Disease: Improving Global Outcomes risk groups. Event probability with finerenone at 4 years was consistent irrespective of baseline urine albumin-to-creatinine ratio, but seemingly more pronounced in patients with higher baseline eGFR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In FIDELITY, finerenone significantly reduced the risk of all-cause and cardiovascular mortality vs. placebo in patients with T2D across a broad spectrum of CKD stages while on treatment, as well as sudden cardiac death in the intention-to-treat population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical trials registration<\/jats:title>\n                  <jats:p>FIDELIO-DKD and FIGARO-DKD are registered with ClinicalTrials.gov, numbers NCT02540993 and NCT02545049, respectively (funded by Bayer AG).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcvp\/pvad001","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T15:49:33Z","timestamp":1673538573000},"page":"183-191","source":"Crossref","is-referenced-by-count":44,"title":["Finerenone and effects on mortality in chronic kidney disease and type 2 diabetes: a FIDELITY analysis"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5640-0332","authenticated-orcid":false,"given":"Gerasimos","family":"Filippatos","sequence":"first","affiliation":[{"name":"Department of Cardiology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens , Rimini 1, Chaidari 124 62, Athens , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0805-8683","authenticated-orcid":false,"given":"Stefan D","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CVK) and Berlin Institute of Health Center for Regenerative Therapies, German Centre for Cardiovascular Research Partner Site Berlin, Charit\u00e9 Universit\u00e4tsmedizin , Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyllis","family":"August","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, New York Presbyterian Hospital\u2013Weill Cornell Medical College , New York, NY , USA"},{"name":"Department of Transplantation Medicine, New York Presbyterian Hospital\u2013Weill Cornell Medical College , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J S","family":"Coats","sequence":"additional","affiliation":[{"name":"Heart Research Institute , 7 Eliza Street, Sydney , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James L","family":"Januzzi","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School, and Baim Institute for Clinical Research , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris","family":"Mankovsky","sequence":"additional","affiliation":[{"name":"National Healthcare University of Ukraine , Kiev , Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1531-4294","authenticated-orcid":false,"given":"Peter","family":"Rossing","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen , Herlev , Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis M","family":"Ruilope","sequence":"additional","affiliation":[{"name":"Cardiorenal Translational Laboratory and Hypertension Unit, Institute of Research imas12 , Madrid , Spain"},{"name":"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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5880-275X","authenticated-orcid":false,"given":"Bertram","family":"Pitt","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Michigan School of Medicine , Ann Arbor, MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9174-4018","authenticated-orcid":false,"given":"Pantelis","family":"Sarafidis","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki , Thessalon\u00edki , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R","family":"Teerlink","sequence":"additional","affiliation":[{"name":"Section of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California San Francisco , San Francisco, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris J","family":"Kapelios","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens , Rimini 1, Chaidari 124 62, Athens , Greece"},{"name":"Department of Cardiology, Laiko General Hospital , Athens , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0812-8490","authenticated-orcid":false,"given":"Martin","family":"Gebel","sequence":"additional","affiliation":[{"name":"Statistics & Data Insights, Bayer AG , Wuppertal , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meike","family":"Brinker","sequence":"additional","affiliation":[{"name":"Cardiology and Nephrology Clinical Development, Bayer AG , Wuppertal , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amer","family":"Joseph","sequence":"additional","affiliation":[{"name":"Research and Development, Chiesi S.p.A. , Parma , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lage","sequence":"additional","affiliation":[{"name":"Cardiology and Nephrology Clinical Development, Bayer SA , S\u00e3o Paulo , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Bakris","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Chicago Medicine , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Richard L. 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