Finerenone and NYHA Functional Class in Heart Failure
John W. Ostrominski, Muthiah Vaduganathan, Brian Claggett, Akshay S. Desai, Pardeep S. Jhund, Carolyn S.P. Lam, Michele Senni, Sanjiv J. Shah, Adriaan A. Voors, Faı̈ez Zannad, Bertram Pitt, Maria Borentian, Katja Rohwedder, James Lay‐Flurrie, Marco Lavagnino, John J.V. McMurray, Scott D. Solomon
Abstract
BACKGROUND: The NYHA functional classification remains an important and widely used metric in heart failure (HF)-oriented clinical care and research. OBJECTIVES: This study aims to evaluate whether the effect of finerenone varies according to NYHA functional class in HF with mildly reduced or preserved ejection fraction. METHODS: In this prespecified analysis of the FINEARTS-HF trial, treatment effects of finerenone according to baseline NYHA functional class (II or III/IV) were examined on the primary endpoint (cardiovascular death and total HF events) and key secondary endpoints. Effects of finerenone on change in NYHA functional class were evaluated using ordinal logistic regression. RESULTS: = 0.93). NYHA functional class improved similarly in the finerenone and placebo arms out to 12 months. The safety profile of finerenone was similar among participants with baseline NYHA functional class III/IV vs II. CONCLUSIONS: In this FINEARTS-HF analysis, finerenone reduced clinical outcomes and improved patient-reported health status in HF with mildly reduced or preserved ejection fraction irrespective of baseline NYHA functional class. (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure [FINEARTS-HF]; NCT04435626).