One of the fundamental parameters for heart failure (HF) diagnosis is the amount of blood that the left ventricle pumps to the aorta in each contraction. This is called the ejection fraction and, depending on its percentage, it is considered normal (between 50% and 70%), slightly reduced (between 41% and 49%) or reduced (less than 40%).
The international FINEARTS-HF trial has confirmed for the first time that fineronone, a drug that has so far been prescribed in HF cases with reduced ejection fraction, also mitigates disease progression and increases the survival of patients with a normal (or preserved) or slightly reduced ejection fraction. This may lead to a change in the clinical guidelines for the treatment of a very large group of people with this disease, since about 50% of HF cases have a normal ejection fraction. To date, this segment of patients has no therapeutic solution beyond sodium-glucose cotransporter type 2 inhibitors (iSGLT2), which have a partial effect.
“These results represent an unprecedented advance in the management of patients with heart failure and preserved ventricular function, since until now their therapeutic options were very limited,” says Dr. Josep Comin, head of the Bio-Heart cardiovascular disease research group at IDIBELL, HUB and CIBERCV and coordinator of the trial in Spain, country that provided more patients only after the United States and China.
The multicenter study, promoted by Bayer and led by Drs. Scott Solomon, from Harvard University, and John V. McMurray, from the University of Glasgow, involved more than 6,000 patients from centers in almost fifty countries around the world, who were followed for an average of 32 months and distributed between the group that received the drug and the placebo group.
Finerone belongs to the drug category called mineralocorticoid receptor antagonists (MRAs), which block the activity of certain steroids produced by the human body that can cause damage to the heart and kidneys. The finerenone-related reduction in morbidity and mortality has been proven in HF cases with reduced ejection fraction, but until now it had not been described in cases of slightly reduced or preserved fraction, so these uses are not included in clinical guidelines. Finerenone administration, often also used to treat chronic kidney disease, reduced the risk of cardiovascular death and heart failure episodes requiring hospitalization in control group patients. For this reason, Dr. Comin concludes that “undoubtedly, the contributions of the FINEARTS-HF study will imply a change in international clinical practice guidelines for the management of heart failure”.
The results of the trial were presented on September 1 in London at the Congress of the European Society of Cardiology, coinciding with the publication in the New Medical Journal Medicine, of which Dr. Comin is a co-author.
The Bellvitge Biomedical Research Institute (IDIBELL) is a biomedical research center created in 2004. It is participated by the Bellvitge University Hospital and the Viladecans Hospital of the Catalan Institute of Health, the Catalan Institute of Oncology, the University of Barcelona and the City Council of L’Hospitalet de Llobregat.
IDIBELL is a member of the Campus of International Excellence of the University of Barcelona HUBc and is part of the CERCA institution of the Generalitat de Catalunya. In 2009 it became one of the first five Spanish research centers accredited as a health research institute by the Carlos III Health Institute. In addition, it is part of the “HR Excellence in Research” program of the European Union and is a member of EATRIS and REGIC. Since 2018, IDIBELL has been an Accredited Center of the AECC Scientific Foundation (FCAECC).