{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:50:16Z","timestamp":1792183816294,"version":"4.4.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC-113-2218-E-008-017"],"award-info":[{"award-number":["NSTC-113-2218-E-008-017"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC-113-2221-E-038-011"],"award-info":[{"award-number":["NSTC-113-2221-E-038-011"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC-114-2314-B-038-126"],"award-info":[{"award-number":["NSTC-114-2314-B-038-126"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010613","name":"Taipei Medical University Hospital","doi-asserted-by":"publisher","award":["113TMUH-TWS-01"],"award-info":[{"award-number":["113TMUH-TWS-01"]}],"id":[{"id":"10.13039\/501100010613","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010613","name":"Taipei Medical University Hospital","doi-asserted-by":"publisher","award":["114TMUH-C01-1"],"award-info":[{"award-number":["114TMUH-C01-1"]}],"id":[{"id":"10.13039\/501100010613","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Finerenone has shown benefit in chronic kidney disease, type 2 diabetes, and heart failure with mildly reduced or preserved ejection fraction (HFmrEF\/HFpEF), but head-to-head data against spironolactone are limited. We compared 12-month effectiveness and safety after finerenone vs spironolactone initiation in heart failure with left ventricular ejection fraction \u226540%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We conducted a retrospective active-comparator, new-user cohort study using the TriNetX Network from 9 July 2021 to 31 March 2025. Adults of both sexes with HFmrEF\/HFpEF initiating finerenone or spironolactone were matched 1:1 by propensity score. The primary outcome was all-cause mortality or heart failure exacerbation. Secondary outcomes included all-cause mortality, heart failure exacerbation, all-cause hospitalization, and acute myocardial infarction; safety outcomes were hyperkalaemia and acute kidney injury. After matching, 1417 patients were included in each group. Finerenone initiation was associated with lower risk of the primary outcome (32.3% vs 41.7%; adjusted hazard ratio [aHR] 0.72, 95% confidence interval [CI] 0.64\u20130.82; P &amp;lt; .001). Lower risks were also observed for all-cause mortality (aHR 0.67, 95% CI 0.51\u20130.87), heart failure exacerbation (aHR 0.73, 95% CI 0.64\u20130.83), and all-cause hospitalization (aHR 0.83, 95% CI 0.76\u20130.91), but not acute myocardial infarction. Hyperkalaemia was less frequent with finerenone (17.9% vs. 22.8%; risk ratio 0.79, 95% CI 0.68\u20130.91); acute kidney injury showed only a borderline difference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Finerenone initiation was associated with lower 12-month clinical event and hyperkalaemia risks than spironolactone initiation. These observational associations should be considered hypothesis-generating and require confirmation in randomized head-to-head trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eschf\/xvag246","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T12:21:46Z","timestamp":1790425306000},"source":"Crossref","is-referenced-by-count":0,"title":["Finerenone vs spironolactone in heart failure with mildly reduced or preserved ejection fraction: a real-world study"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4550-3310","authenticated-orcid":false,"given":"Pham Trong Khang","family":"Ha","sequence":"first","affiliation":[{"name":"International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chieh-Ju","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of 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,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University Hospital , No. 252, Wuxing Street, Xinyi District, Taipei 11031 ,","place":["Taiwan"]},{"name":"Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University , No. 250, Wuxing Street, Xinyi District, Taipei 11031 ,","place":["Taiwan"]},{"name":"Taipei Heart Institute, Taipei Medical University , No. 250, Wuxing Street, Xinyi District, Taipei 11031 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Cheng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Taipei Medical University Hospital , Taipei ,","place":["Taiwan"]},{"name":"School of Pharmacy, College of Pharmacy, Taipei Medical University , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Yao","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University Hospital , No. 252, Wuxing Street, Xinyi District, Taipei 11031 ,","place":["Taiwan"]},{"name":"Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University , No. 250, Wuxing Street, Xinyi District, Taipei 11031 ,","place":["Taiwan"]},{"name":"Taipei Heart Institute, Taipei Medical University , No. 250, Wuxing Street, Xinyi District, Taipei 11031 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0757-1901","authenticated-orcid":false,"given":"Yu-Hsuan","family":"Shao","sequence":"additional","affiliation":[{"name":"Health Data Analytics and Statistics Center, Office of Data Science, Taipei Medical University , Taipei ,","place":["Taiwan"]},{"name":"Clinical Big Data Research Center, Taipei Medical University Hospital , Taipei ,","place":["Taiwan"]},{"name":"Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9493-7325","authenticated-orcid":false,"given":"Chien-Yi","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University Hospital , No. 252, Wuxing Street, Xinyi District, Taipei 11031 ,","place":["Taiwan"]},{"name":"Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University , No. 250, Wuxing Street, Xinyi District, Taipei 11031 ,","place":["Taiwan"]},{"name":"Taipei Heart Institute, Taipei Medical University , No. 250, Wuxing Street, Xinyi District, Taipei 11031 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"2026101616272140900_xvag246-B1","doi-asserted-by":"publisher","first-page":"102491","DOI":"10.1016\/j.jchf.2025.03.037","article-title":"Etiology of heart failure across the ejection fraction spectrum and association with prognosis","volume":"13","author":"Kozman","year":"2025","journal-title":"JACC Heart Fail"},{"key":"2026101616272140900_xvag246-B2","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.cardfail.2024.07.001","article-title":"HF STATS 2024: heart failure epidemiology and outcomes statistics: an updated 2024 report from the Heart Failure Society of America","volume":"31","author":"Bozkurt","year":"2025","journal-title":"J Card 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