Finerenone and Left Ventricular Hypertrophy in Chronic Kidney Disease and Type 2 Diabetes

作者：Gerasimos Filippatos, Stefan D. Anker, George L. Bakris, Peter Rossing, Luís M. Ruilope, Andrew J.S. Coats, Stephan von Haehling, Piotr Ponikowski, Giuseppe Rosano, Meike Brinker, Alfredo E. Farjat, Luke Roberts, Bertram Pitt, the FIDELIO-DKD and FIGARO-DKD investigators · 发表于：ESC Heart Failure · 年份：2024 · DOI：10.1002/ehf2.14962 · 被引用次数：15 · 研究领域：Hormonal Regulation and Hypertension、Blood Pressure and Hypertension Studies、Heart Failure Treatment and Management

Abstract Aims Left ventricular hypertrophy (LVH) has been associated with an increased risk of cardiovascular (CV) disease and linked to increased morbidity and mortality. In patients with chronic kidney disease (CKD) and type 2 diabetes (T2D), hypertension is common, and patients with these co-morbidities additionally have a high prevalence of LVH. This analysis of the prespecified pooled FIDELITY analysis comprising the randomized, double-blind, placebo-controlled, multicentre FIDELIO-DKD and FIGARO-DKD phase III studies aimed to explore the CV and kidney effects of finerenone, a nonsteroidal mineralocorticoid receptor antagonist, in patients with CKD and T2D stratified by a diagnosis of LVH at baseline. Methods and results A diagnosis of LVH in the FIDELITY patient population was determined at baseline using investigator-reported electrocardiogram (ECG) findings. The two efficacy outcomes, assessed by baseline LVH, were the composite CV outcome of time to CV death, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for heart failure (HHF), and a composite kidney outcome of time to onset of kidney failure, a sustained decrease in estimated glomerular filtration rate (eGFR) ≥57% from baseline over ≥4 weeks, or kidney-related death. Safety outcomes by baseline LVH were reported as treatment-emergent adverse events. At baseline out of 13 026 patients in FIDELITY, 96.5% had hypertension and 9.6% had investigator-reported LVH. The relative risk reduction for t...