Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction
Résumé
METHODS A total of 6,001 patients with HF with NYHA functional class II, III, and IV, a left ventricular ejection fraction of $40%, evidence of structural heart disease, and elevated natriuretic peptide levels were randomized to finerenone or placebo. BMI (kg/m 2 ) was examined using World Health Organization categories, namely, underweight/normal weight (<25.0 kg/m 2 ; n ¼ 1,306); overweight (25.0-29.9 kg/m 2 ; n ¼ 1,990); obesity class I (30.0-34.9 kg/m 2 ; n ¼ 1,546); obesity class II (35.0-39.9 kg/m 2 ; n ¼ 751); and obesity class III ($40 kg/m 2 ; n ¼ 395). The primary outcome was cardiovascular death and total worsening HF events. RESULTS Data on baseline BMI were available for 5,988 patients (median: 29.2 kg/m 2 ; Q1-Q3: 25.5-33.6 kg/m 2 ). Compared with patients who were underweight/normal weight, those with obesity class II or III had a higher risk of the primary outcome (underweight/normal weight, reference; overweight, unadjusted rate ratio: 0.96 [95% CI: 0.81-1.15]; obesity class I: 1.04 [95% CI: 0.86-1.26]; obesity class II-III: 1.26 [95% CI: 1.03-1.54]). The effect of finerenone on the primary outcome did not vary by baseline BMI (underweight/normal weight, rate ratio: 0.80 [95%]
Domaines
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