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 Sub-editor: Dr Joshua Rowland Dr Joshua Rowland is a cardiology registrar working in the North West Deanery. He graduated from the University of Manchester
Author Sub-editor: Dr Atmadeep Banerjee Dr Atmadeep Banerjee is an ST4 Cardiology Registrar in the Kent, Surrey and Sussex deanery. He graduated from Calcutta National
Authors Heartbeat Sub-Editor: Sandeep Singh Dr Sandeep Singh is a Cardiology Clinical Fellow at Nottingham University Hospitals NHS Trust. After graduating from India, he completed
Authors Heartbeat Sub-Editor: Khin Kay Kay Kyaw I am currently working as cardiology specialist registrar ST6 at southwest peninsula region while also working as an