FINEARTS-HF: Improving outcomes in heart failure with preserved or mildly reduced ejection fraction.

The FINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients With Heart Failure, N Engl J Med 2024; 391(16):1475-1485) trial evaluated finerenone, a nonsteroidal mineralocorticoid receptor antagonist, in patients with left ventricular ejection fraction 40% or greater. Finerenone reduced the composite risk of hospitalization for heart failure or cardiovascular death by 16% relative to placebo (rate ratio 0.84, P = .007), primarily by lowering admissions for heart failure. Finerenone is the first mineralocorticoid receptor antagonist to improve outcomes in this patient population.