Mineralocorticoid receptor antagonists (MRA) have an established prognostic benefit in patients with heart failure with reduced ejection fraction (HFrEF)(1). In the TOPCAT trial, spironolactone for heart failure with preserved ejection fraction (HFpEF) failed to meet statistical significance for the primary outcome of a composite of cardiovascular death, aborted cardiac arrest and heart failure hospitalisation(2). However, post hoc analysis of the TOPCAT revealed geographical variation in treatment response, suggesting potential clinical benefit of MRA in HFpEF. Finerenone, a novel nonsteroidal MRA, has been shown to have prognostic benefit in patients with chronic kidney disease and type 2 diabetes (T2DM). This editorial reviews the emerging evidence for its use in heart failure patients.
Author Heartbeat Sub-Editor: Dr Khin Kay Kay Kyaw I am currently working as cardiology specialist registrar ST6 at southwest peninsula region while also working as
Author Sub-editor: Dr Pok-Tin Tang Dr Pok-Tin Tang is an ST5 cardiology registrar in the Thames Valley deanery, currently undertaking a period of out of
Author Sub-editor: Dr May Hu Dr May Hu is a cardiology trainee in the North West deanery. She graduated with First Class Honours from the University
Author Sub-editor: Dr Jhiamluka Solano Dr Jhiamluka Solano is a cardiology resident doctor (ST6) in the Yorkshire and Humber Deanery, currently undertaking a DPhil (PhD)