Finerenone Use in Heart Failure Patients with Type 2 Diabetes and Kidney Disease: An Analysis of the FINE-TURK Registry.
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Yadigar Serap, Akgür Suat, Güvenç Tolga Sinan, Sezen Mehmet, Özcan Büşra, Yıldırım Ayaz Elif, Doğantekin Betül, Atay İlker, Değer Serpil Müge, Demir Mustafa, Koyuncu Sümeyra, Yılmaz Üstün, İnci Ayça, Çolak Hülya, Demirelli Bülent, Tuğlular Serhan, Oğuz Ebru Gök, Aylı Mehmet Deniz, Avanaz Ezgi, Yılmaz Fatih, Doğan Beyza, Karaköse Süleyman, Karakan Mine Şebnem, Demirci Bahar Gürlek, Türkmen Kültigin, Baloğlu İsmail, Batmazoğlu Mehmet, Mert Mehmet, Aydın Emre, Aydın Fatma Yılmaz, Parmaksız Ergün, Özdemir Pınar, Ediz Bartu, Aydın Zeki, Demir Mehmet Emin, Sezer Siren, Ünver Suat, Baykal Öznur, Akman Çakmak Beril, Altuntaş Atila, İslam Mahmud, Koçak Yücel Fatma Sibel, Mert Meral, Dursun Belda, Eren Necmi, Demir Simge Bardak, Güven Alper Tuna, Bilgiç Mukadder Ayşe, Erdut Arda, Keskin Gülşah, Şahin Ahmet Ziya, Horoz Mehmet, Tekinyıldız Merve, Duranay Murat, Yalın Serkan Feyyaz, Altunok Murat, Sarı Funda, Sarı Ramazan, Torun Dilek, Kahvecioğlu Serdar, Yalçınkaya A Serap, Akagün Tülin, Çelik Hüseyin, Kazan Sinan, Öztürk İlyas, Polat Mehmet, Aydın Mehmet Fethullah, Meşe Meral, Yavuz Umut Melike Hazal, Demirezen Asil, Derici Ülver, Altun Eda, Şengül Erkan, Bakırdöğen Serkan, Kara Ekrem, Akgöl Cüneyt, Aykent Mahmut Başar, İlter Ali, Ekmekçi Ahmet, Ulu Sena, Arıcı Mustafa, Arı Bakır Elif
Аннотация
METHODS: This was a retrospective, multicenter, observational registry analysis conducted across 56 centers in Türkiye. Among 1,168 patients initially enrolled, 918 patients with available heart failure status and ejection fraction data were included. Patients were categorized according to the presence of heart failure, and heart failure patients were further classified as HFrEF or HFmrEF/HFpEF. Three-month changes in serum potassium, estimated glomerular filtration rate, and albuminuria were assessed. Safety endpoints included serum potassium ≥ 5.5 mEq/L and eGFR ≤ 25 mL/min/1.73 m² at three months. The primary renal efficacy endpoint was a > 30% reduction in albuminuria from baseline.
RESULTS: Of 918 patients, 133 had heart failure. Patients with heart failure were older and had lower baseline eGFR compared with those without heart failure. They were also more likely to receive a lower starting dose of finerenone. At three months, changes in serum potassium, eGFR, and albuminuria were not significantly different between patients with and without heart failure. No excess risk of hyperkalemia or worsening renal function was observed in the heart failure group. In adjusted analyses, heart failure was associated with a greater likelihood of achieving a > 30% reduction in albuminuria. No significant differences in short-term renal safety or efficacy outcomes were observed between HFrEF and HFmrEF/HFpEF subgroups.
CONCLUSIONS: In this nationwide real-world registry, patients with heart failure who were treated with finerenone had a higher-risk baseline profile, including older age and lower eGFR. Despite this, finerenone was not associated with increased short-term renal safety concerns and was linked to a clinically meaningful reduction in albuminuria. These findings support the short-term renal safety and potential efficacy of finerenone in patients with type 2 diabetes, kidney disease, and heart failure.