Finerenone Reduces New-Onset Atrial Fibrillation in Patients With Chronic Kidney Disease and Type 2 Diabetes

• Published in: Journal of the American College of Cardiology 2021-07, Vol.78 (2), p.142-152
• Main Authors: Filippatos, Gerasimos, Bakris, George L., Pitt, Bertram, Agarwal, Rajiv, Rossing, Peter, Ruilope, Luis M., Butler, Javed, Lam, Carolyn S.P., Kolkhof, Peter, Roberts, Luke, Tasto, Christoph, Joseph, Amer, Anker, Stefan D.
• Format: Article
• Language: English
• Subjects: Aged; Atrial Fibrillation - complications; Atrial Fibrillation - mortality; Atrial Fibrillation - prevention & control; chronic kidney disease; clinical trial; Diabetes Mellitus, Type 2 - complications; Female; finerenone; Humans; Incidence; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - mortality; Kidney Failure, Chronic - prevention & control; Male; Middle Aged; mineralocorticoid receptor antagonist; Mineralocorticoid Receptor Antagonists - therapeutic use; Naphthyridines - therapeutic use; new-onset atrial fibrillation; type 2 diabetes
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2021.04.079

Patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) are at risk of atrial fibrillation or flutter (AFF) due to cardiac remodeling and kidney complications. Finerenone, a novel, selective, nonsteroidal mineralocorticoid receptor antagonist, inhibited cardiac remodeling in preclinical models. This work aims to examine the effect of finerenone on new-onset AFF and cardiorenal effects by history of AFF in the Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease (FIDELIO-DKD) study. Patients with CKD and T2D were randomized (1:1) to finerenone or placebo. Eligible patients had a urine albumin-to-creatinine ratio ≥30 to ≤5,000 mg/g, an estimated glomerular filtration rate (eGFR) ≥25 to