Meta-analysis on the cardiovascular disease efficacy and safety of finerenone
YANG Xuexue
TIAN Rong
ZHENG Xiaoqing
HE Ye
LIU Yijie
XIONG Xiaofang
Abstract：Objective To systematically evaluate the effectiveness and safety of the novel non-steroidal mineralocorticoid receptor antagonist finerenone in cardiovascular diseases.Methods Randomized controlled studies comparing finerenone with the control group were retrieved using database search tools,and then a meta-analysis was conducted for comprehensive assessment.Results A total of 8 articles were included,involving 21,328 patients.Compared with the control group,the all-cause mortality rate was lower in the finerenone group(OR=0.9,95%CI:0.83～0.99;heterogeneity:P=0.550,I2=0%);the risk of major adverse cardiovascular events(MACE)was significantly reduced in the finerenone group(OR=0.86,95%CI:0.78～0.94;heterogeneity:P=0.990,I2=0%);the risk of heart failure occurrence and rehospitalization due to heart failure was significantly reduced in the finerenone group(OR=0.79,95%CI:0.72～0.88;heterogeneity:P=0.750,I2=0%);the incidence of hyperkalemia was increased in the finerenone group(OR=2.17,95%CI:1.93～2.44;heterogeneity:P=0.180,I2=36%);the incidence of atrial flutter and atrial fibrillation in the finerenone group(4.24%)was lower than that in the control group(5.39%),mainly due to the reduction in the incidence of atrial fibrillation(3.67%vs.4.82%).There were no statistically significant differences in the risk of cardiovascular death(OR=0.89,95%CI:0.79～1.00;heterogeneity P=0.87,I2=0%),the risk of myocardial infarction(OR=0.91,95%CI:0.74～1.12;heterogeneity P=0.510,I2=0%),the risk of adverse effects(OR=0.97,95%CI:0.88～1.06;heterogeneity P=0.910,I2=0%),and the risk of drug discontinuation due to adverse effects(OR=1.15,95%CI:1.00～1.32;heterogeneity P=0.610,I2=0%).Conclusion Compared with the control group,finerenone reduces the risk of all-cause mortality,reduces the occurrence of MACE events,lowers the risk of heart failure and rehospitalization due to heart failure,and reduces the risk of atrial fibrillation,but increases the risk of hyperkalemia;there are no significant differences between the two groups in terms of cardiovascular death,myocardial infarction,adverse effects,and drug discontinuation due to adverse effects.
Keywords：finerenonecardiovascular diseasesatrial flutteratrial fibrillationmeta-analysis
Publication Date：2026-01-20
Online Publishing Date：2026-03-25(First online date of this platform, not the publication date of the document)
Pages：5( 32-36 )