Modifiability of Composite Cardiovascular Risk Associated With Chronic Kidney Disease in Type 2 Diabetes With Finerenone

作者：Rajiv Agarwal, Bertram Pitt, Peter Rossing, Stefan D. Anker, Gerasimos Filippatos, Luís M. Ruilope, Csaba P. Kövesdy, Katherine R. Tuttle, Muthiah Vaduganathan, Christoph Wanner, Sameer Bansilal, Martin Gebel, Amer Joseph, Robert Lawatscheck, George L. Bakris · 发表于：JAMA Cardiology · 年份：2023 · DOI：10.1001/jamacardio.2023.1505 · 被引用次数：35 · 研究领域：Hormonal Regulation and Hypertension、Blood Pressure and Hypertension Studies、Heart Failure Treatment and Management

Importance: It is currently unclear whether chronic kidney disease (CKD)-associated cardiovascular risk in type 2 diabetes (T2D) is modifiable. Objective: To examine whether cardiovascular risk can be modified with finerenone in patients with T2D and CKD. Design, Setting, and Participants: Incidence rates from Finerenone in Chronic Kidney Disease and Type 2 Diabetes: Combined FIDELIO-DKD and FIGARO-DKD Trial Programme Analysis (FIDELITY), a pooled analysis of 2 phase 3 trials (including patients with CKD and T2D randomly assigned to receive finerenone or placebo) were combined with National Health and Nutrition Examination Survey data to simulate the number of composite cardiovascular events that may be prevented per year with finerenone at a population level. Data were analyzed over 4 years of consecutive National Health and Nutrition Examination Survey data cycles (2015-2016 and 2017-2018). Main Outcomes and Measures: Incidence rates of cardiovascular events (composite of cardiovascular death, nonfatal stroke, nonfatal myocardial infarction, or hospitalization for heart failure) were estimated over a median of 3.0 years by estimated glomerular filtration rate (eGFR) and albuminuria categories. The outcome was analyzed using Cox proportional hazards models stratified by study, region, eGFR and albuminuria categories at screening, and cardiovascular disease history. Results: This subanalysis included a total of 13 026 participants (mean [SD] age, 64.8 [9.5] years; 9088 male [...