Finerenone in heart failure with left ventricular ejection fraction ≥40%: a correspondence

Finerenone, the first nonsteroidal mineralocorticoid receptor antagonist approved by the U.S. Food and Drug Administration for treating heart failure (HF) with mildly reduced ejection fraction and HF with preserved ejection fraction reduces morbidity and mortality by mitigating inflammation and fibrosis. The FINEARTS-HF (Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction) trial demonstrated significant benefits, particularly after recent HF events, with ongoing studies evaluating broader applications across the cardio-kidney-metabolic spectrum.