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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Modifiability of Composite Cardiovascular Risk Associated With Chronic Kidney Disease in Type 2 Diabetes With
Rajiv Agarwal1, Bertram Pitt2, Peter Rossing3,4
1Richard L. Roudebush VA Medical Center and Indiana University, Indiana University School of Medicine, Indianapolis.
JAMA Cardiology
|June 14, 2023
Summary
Finerenone treatment may reduce cardiovascular risk in patients with type 2 diabetes and chronic kidney disease. This medication could prevent numerous cardiovascular events annually at a population level, particularly in those with higher eGFR.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Cardiovascular disease (CVD) is a leading cause of mortality in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD).
- The modifiable nature of CKD-associated cardiovascular risk in T2D remains an area of active investigation.
Purpose of the Study:
- To investigate the efficacy of finerenone in modifying cardiovascular risk among patients with T2D and CKD.
- To estimate the population-level impact of finerenone treatment on preventing cardiovascular events.
Main Methods:
- A pooled analysis of the FIDELIO-DKD and FIGARO-DKD trials (FIDELITY) was conducted.
- Data were combined with National Health and Nutrition Examination Survey data to simulate population-level event prevention.
- Cardiovascular event incidence was analyzed based on estimated glomerular filtration rate (eGFR) and albuminuria categories.
Main Results:
- Lower eGFR and higher albuminuria were associated with increased cardiovascular event incidence.
- Finerenone demonstrated a significant reduction in composite cardiovascular risk (HR, 0.86; 95% CI, 0.78-0.95).
- Simulations indicated that one year of finerenone treatment could prevent over 38,000 cardiovascular events in eligible individuals.
Conclusions:
- Finerenone treatment appears to modify CKD-associated cardiovascular risk in patients with T2D.
- The benefits of finerenone were observed across various eGFR and albuminuria strata.
- Urine albumin-to-creatinine ratio (UACR) screening can identify patients who may benefit significantly from finerenone therapy.
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