{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:12:26Z","timestamp":1791637946341,"version":"4.3.4"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T00:00:00Z","timestamp":1644278400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2022,2,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Chronic kidney disease and type 2 diabetes are independently associated with heart failure (HF), a leading cause of morbidity and mortality. In the FIDELIO-DKD (Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease) and FIGARO-DKD (Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease) trials, finerenone (a selective, nonsteroidal mineralocorticoid receptor antagonist) improved cardiovascular outcomes in patients with albuminuric chronic kidney disease and type 2 diabetes. These prespecified analyses from FIGARO-DKD assessed the effect of finerenone on clinically important HF outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Patients with type 2 diabetes and albuminuric chronic kidney disease (urine albumin-to-creatinine ratio \u226530 to &lt;300 mg\/g and estimated glomerular filtration rate \u226525 to \u226490 mL per min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      , or urine albumin-to-creatinine ratio \u2265300 to \u22645000 mg\/g and estimated glomerular filtration rate \u226560 mL per min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ), without symptomatic HF with reduced ejection fraction, were randomized to finerenone or placebo. Time-to-first-event outcomes included new-onset HF (first hospitalization for HF [HHF] in patients without a history of HF at baseline); cardiovascular death or first HHF; HF-related death or first HHF; first HHF; cardiovascular death or total (first or recurrent) HHF; HF-related death or total HHF; and total HHF. Outcomes were evaluated in the overall population and in prespecified subgroups categorized by baseline HF history (as reported by the investigators).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall, 7352 patients were included in these analyses; 571 (7.8%) had a history of HF at baseline. New-onset HF was significantly reduced with finerenone versus placebo (1.9% versus 2.8%; hazard ratio [HR], 0.68 [95% CI, 0.50\u20130.93];\n                      <jats:italic>P<\/jats:italic>\n                      =0.0162). In the overall population, the incidences of all HF outcomes analyzed were significantly lower with finerenone than placebo, including an 18% lower risk of cardiovascular death or first HHF (HR, 0.82 [95% CI, 0.70\u20130.95];\n                      <jats:italic>P<\/jats:italic>\n                      =0.011), a 29% lower risk of first HHF (HR, 0.71 [95% CI, 0.56\u20130.90];\n                      <jats:italic>P<\/jats:italic>\n                      =0.0043) and a 30% lower rate of total HHF (rate ratio, 0.70 [95% CI, 0.52\u20130.94]). The effects of finerenone on improving HF outcomes were not modified by a history of HF. The incidence of treatment-emergent adverse events was balanced between treatment groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The results from these FIGARO-DKD analyses demonstrate that finerenone reduces new-onset HF and improves other HF outcomes in patients with chronic kidney disease and type 2 diabetes, irrespective of a history of HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT02545049.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.121.057983","type":"journal-article","created":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T11:20:33Z","timestamp":1636802433000},"page":"437-447","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":287,"title":["Finerenone Reduces Risk of Incident Heart Failure in Patients With Chronic Kidney Disease and Type 2 Diabetes: Analyses From the FIGARO-DKD Trial"],"prefix":"10.1161","volume":"145","clinical-trial-number":[{"clinical-trial-number":"nct02545049","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5640-0332","authenticated-orcid":true,"given":"Gerasimos","family":"Filippatos","sequence":"first","affiliation":[{"name":"National and Kapodistrian University of Athens, School of Medicine, Department of Cardiology, Attikon University Hospital, Greece (G.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0805-8683","authenticated-orcid":true,"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (Charit\u00e9 Campus Virchow-Klinikum) and Berlin Institute of Health Center for Regenerative Therapies, German Centre for Cardiovascular Research Partner Site Berlin, Charit\u00e9 Universit\u00e4tsmedizin (S.D.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8355-7100","authenticated-orcid":true,"given":"Rajiv","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Richard L. Roudebush VA Medical Center and Indiana University, Indianapolis (R.A.)."}],"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 (L.M.R.)."},{"name":"CIBER en Enfermedades Cardiovasculares, Hospital Universitario 12 de Octubre, Madrid, Spain (L.M.R.)."},{"name":"Faculty of Sport Sciences, European University of Madrid, Spain (L.M.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rossing","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Gentofte, Denmark (P.R.)."},{"name":"Department of Clinical Medicine, University of Copenhagen, Denmark (P.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1183-1267","authenticated-orcid":true,"given":"George L.","family":"Bakris","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Chicago Medicine, IL (G.L.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Tasto","sequence":"additional","affiliation":[{"name":"Research and Development, Statistics and Data Insights (C.T.), Bayer AG, Wuppertal, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amer","family":"Joseph","sequence":"additional","affiliation":[{"name":"Research and Development, Cardiology and Nephrology Clinical Development (A.J.), Bayer AG, Wuppertal, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kolkhof","sequence":"additional","affiliation":[{"name":"Preclinical Research Cardiovascular, Pharmaceuticals, Research and Development (P.K.), Bayer AG, Wuppertal, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9893-2759","authenticated-orcid":true,"given":"Andrea","family":"Lage","sequence":"additional","affiliation":[{"name":"Cardiology and Nephrology Clinical Development, Bayer SA, S\u00e3o Paulo, Brazil (A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertram","family":"Pitt","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Michigan School of Medicine, Ann Arbor (B.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the FIGARO-DKD Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.11.053"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31829e8776"},{"key":"e_1_3_2_4_2","volume-title":"USRDS Annual data report. 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