JACC This Week

Podcast Overview The podcast, hosted by Valentin Fuster on January 21, 2025, provides an in-depth review of the FINEARTS-HF trial, which evaluated the efficacy of the non-steroidal mineralocorticoid receptor antagonist finerenone in patients with heart failure and mildly reduced or preserved ejection fraction (HFmrEF/HFpEF). The episode highlights findings published in the Journal of the American College of Cardiology (JACC). Introduction to the FINEARTS-HF Trial (00:03:19 – 00:05:56) The FINEARTS-HF trial demonstrated that finerenone reduced heart failure events by 16% compared to placebo in patients with HFmrEF/HFpEF. However, cardiovascular death rates were similar between groups, making the overall clinical impact moderate. Finerenone's Impact on Quality of Life (00:05:59 – 00:12:46) The trial assessed quality of life using the Kansas City Cardiomyopathy Questionnaire (KCCQ), revealing only a slight improvement (1.62 points) with finerenone. Critics, including the FDA, questioned the clinical relevance of these results and suggested the need for simpler, more meaningful patient-reported outcome measures. Finerenone in Patients with Recent Worsening Heart Failure (00:12:58 – 00:20:30) Patients with recent worsening heart failure showed a greater absolute benefit from finerenone, as they were at higher risk of recurrent events and cardiovascular death. However, further studies are needed to confirm these findings. Finerenone's Role in Obese Patients with HFmrEF/HFpEF (00:20:31 – 00:25:20) In obese patients, the benefits of finerenone were consistent across body mass index (BMI) categories, with a possible greater effect in those with higher BMI. Nevertheless, the reliance on BMI as a metric for obesity was criticized, and alternative measures were recommended. Finerenone and Kidney Outcomes (00:25:23 – 00:40:52) Finerenone showed a modest reduction in albuminuria but did not significantly alter kidney disease progression. Initial declines in glomerular filtration rate (GFR) were noted but should not automatically lead to discontinuation of therapy. Mixed findings highlight the need for more research to understand its renal effects. Conclusion (00:40:54 – 00:44:05) The FINEARTS-HF trial was recognized as a landmark study, showcasing modest benefits of finerenone in a challenging patient population. The podcast calls for continued research to refine quality of life metrics, better understand obesity's role in HFmrEF/HFpEF, and explore finerenone's long-term renal and cardiovascular impacts.

Podcast Overview The podcast, hosted by Valentin Fuster on January 21, 2025, provides an in-depth review of the FINEARTS-HF trial, which evaluated the efficacy of the non-steroidal mineralocorticoid receptor antagonist finerenone in patients with heart failure and mildly reduced or preserved ejection fraction (HFmrEF/HFpEF). The episode highlights findings published in the Journal of the American College of Cardiology (JACC). Introduction to the FINEARTS-HF Trial (00:03:19 – 00:05:56) The FINEARTS-HF trial demonstrated that finerenone reduced heart failure events by 16% compared to placebo in patients with HFmrEF/HFpEF. However, cardiovascular death rates were similar between groups, making the overall clinical impact moderate. Finerenone's Impact on Quality of Life (00:05:59 – 00:12:46) The trial assessed quality of life using the Kansas City Cardiomyopathy Questionnaire (KCCQ), revealing only a slight improvement (1.62 points) with finerenone. Critics, including the FDA, questioned the clinical relevance of these results and suggested the need for simpler, more meaningful patient-reported outcome measures. Finerenone in Patients with Recent Worsening Heart Failure (00:12:58 – 00:20:30) Patients with recent worsening heart failure showed a greater absolute benefit from finerenone, as they were at higher risk of recurrent events and cardiovascular death. However, further studies are needed to confirm these findings. Finerenone's Role in Obese Patients with HFmrEF/HFpEF (00:20:31 – 00:25:20) In obese patients, the benefits of finerenone were consistent across body mass index (BMI) categories, with a possible greater effect in those with higher BMI. Nevertheless, the reliance on BMI as a metric for obesity was criticized, and alternative measures were recommended. Finerenone and Kidney Outcomes (00:25:23 – 00:40:52) Finerenone showed a modest reduction in albuminuria but did not significantly alter kidney disease progression. Initial declines in glomerular filtration rate (GFR) were noted but should not automatically lead to discontinuation of therapy. Mixed findings highlight the need for more research to understand its renal effects. Conclusion (00:40:54 – 00:44:05) The FINEARTS-HF trial was recognized as a landmark study, showcasing modest benefits of finerenone in a challenging patient population. The podcast calls for continued research to refine quality of life metrics, better understand obesity's role in HFmrEF/HFpEF, and explore finerenone's long-term renal and cardiovascular impacts.

Harlan M. Krumholz, MD, SM, Editor-in-Chief of JACC, speaks with Ania Jastreboff, MD, PhD, in this 8 part video series. In this portion, they discuss obesity as a disease.

In this eight part video series, JACC Editor-in-Chief Harlan M. Krumholz, MD, SM, and Ania Jastreboff, MD, PhD, discuss obesity. In this discussion, they review the language around obesity and taking care to meet patients where they are.

Harlan M. Krumholz, MD, SM, Editor-in-Chief of JACC, speaks with Ania Jastreboff, MD, PhD, in this 8 part video series. In this video, they discuss how cardiologists can use medications to treat obesity.

Harlan M. Krumholz, MD, SM, Editor-in-Chief of JACC, speaks with Ania Jastreboff, MD, PhD, in this 8 part video series. In this portion, they discuss concerns around the range of popular obesity medications today.

Harlan M. Krumholz, MD, SM, Editor-in-Chief of JACC, speaks with Ania Jastreboff, MD, PhD, in this 8 part video series. In this portion, they discuss patients with obesity and society's view of obesity, as well as the role of the CV physician in shifting the culture around obesity.

Harlan M. Krumholz, MD, SM, Editor-in-Chief of JACC, speaks with Ania Jastreboff, MD, PhD, in this 8 part video series. In this portion, they discuss if patients can be healthy and have obesity, as well as the many impacts that obesity can have on patients.

Harlan M. Krumholz, MD, SM, Editor-in-Chief of JACC, speaks with Ania Jastreboff, MD, PhD, in this 8 part video series. In this portion, they discuss how and why cardiovascular physicians can and should learn about the medications to treat patients with obesity.

Harlan M. Krumholz, MD, SM, Editor-in-Chief of JACC, speaks with Ania Jastreboff, MD, PhD, in this 8 part video series. In this portion, they discuss why cardiologists should care about obesity, and how JACC is raising awareness of treating obesity and helping patients.