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.