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Finerenone’s Diuretic Impact | Kestra’s IPO
March 3, 2025
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Together with
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“Good question at WAFIB2025 – Has finerenone been compared to spironolactone? No. – Guess why? Hint: industry dominates our research enterprise.”
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John Mandrola, MD
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Coronary artery calcium (CAC) is recognized as a risk factor for future heart disease. Fortunately, new solutions are becoming available for calculating CAC scores from CT scans — and can help people avoid future cardiac events. Head over to our sister-publication, The Imaging Wire, for an interview with Dr. Suzy McKinney from MGB and Jason Knapp from Riverain Technologies about these new developments.
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Cardiology Pharmaceuticals
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Finerenone (Bayer’s Kerendia) seems to be the gift that keeps on giving, and we can now add the ability to reduce worsening HF events in patients on diuresis to its growing list of benefits thanks to a new JAMA substudy of the FINEARTS-HF trial.
- FINEARTS-HF explored the effects of finerenone in 6k HFmrEF/HFpEF patients and found that the drug significantly reduced worsening HF events and CV death versus placebo.
- HF patients commonly face periods of stability interrupted by episodes of worsening symptoms and volume retention which causes physicians to put them on diuresis.
- Due to financial incentives and patient preference, oral diuretics tend to be more popular than intravenous loop diuretics because they don’t require in-patient care.
Diving deeper into the data from the FINEARTS-HF trial, researchers found that patients who were given more intense diuretic regimens (n=1,250) during worsening HF had nearly 3x higher death rates than those without worsening HF.
- Patients on intense diuretic regimens faced a death rate of 11.6 per 100 patient-years compared with 4.5 per 100 patient-years for patients without worsening HF who didn’t need diuretics.
Where finerenone really shined was in reducing the death rate in patients on diuretics by cutting down on the need for more intense regimens.
- Encouragingly, patients on finerenone saw an 11% decrease in diuretic intensification, meaning that finerenone helped avoid the need for intravenous loop diuretics.
- This contributed to a 15% reduction in the study’s overall composite endpoint of cardiovascular death, HF hospitalization, and urgent HF visits.
The Takeaway
We already know that finerenone is capable of reducing worsening HF and CV death, but understanding which symptoms it reduces can help us fine tune exactly which patients need it and when, especially as more research trickles in.
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Vista.ai’s Cardiac MRI Case Studies
It’s easy to claim AI improves Cardiac MRI workflows, but it’s a lot harder to back those claims up. Tune in to these discussions with imaging experts to see how Vista Cardiac lives up to its promise of faster, more consistent, and reliable CMR scans.
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Configure Your PCI Study
See for yourself how cardiac imagers use GE HealthCare’s Centricity Cardio Enterprise Universal Viewer to do their PCI studies, including configurable viewport setup and side-by-side comparisons.
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Redefining Percutaneous Coronary Intervention
Learn about the AGENT™ Drug-Coated Balloon from Boston Scientific and how this technology is expanding the treatment options for patients with in-stent restenosis in the U.S. Rx only. (Sponsored by Boston Scientific)
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- Kestra’s IPO: Kestra Medical Technologies is going public with the goal of raising up to $155M to hire new sales representatives and clinical care specialists while investing in its supply chain and revenue cycle management capabilities. Kestra’s claim to fame is its Assure wearable cardioverter defibrillator which prevents sudden cardiac arrest by identifying dangerous arrhythmias and delivering shocks for restoring normal heart rhythm. The Assure device has already been worn by more than 17k patients.
- SPECT/CT Two-for-One CAC Scoring: A paper in JACC: Advances highlighted a novel technique to use the CT component of SPECT/CT myocardial perfusion imaging scans to generate coronary artery calcium scores. In a study of 12.3k patients, researchers found SPECT/CT-generated CAC scores were highly predictive of MACE, with rates highest in CAC patients independent of ischemic ECG changes (range of 9.6% to 7%) and lowest in those without CAC (range to 0.5% to 1.9%).
- Heartflow Rebrands for CAD: Already well known for its AI-based cardiac CT evaluations, Heartflow is rebranding to underscore its focus on delivering high-quality tools that help clinicians prevent, diagnose, and treat CAD. Heartflow’s AI-powered CCTA assessments have already helped more than 400k patients, and with the new rebrand, the company aims to evaluate CCTA exams for signs of CAD while helping guide patient management.
- Body Composition Predicts Mortality: A new study in Radiology suggests low-dose CT scans could be leveraged to produce data on body composition that predicts mortality. In 20.7k patients drawn from the NLST trial, researchers used CT data to calculate epicardial adipose tissue and track it over time. Individuals with atypical declines in EAT volume had 34% higher risk of all-cause mortality, while atypical increases had a 15% higher risk. Similar correlations were found for cardiovascular and lung cancer mortality.
- BSCI’s Pacemaker Recall: The FDA has now categorized the safety issues with Boston Scientific Accolade pacemakers as a Class I recall due to more than 800 injuries and two deaths linked to the products. These concerns were first reported in December and the FDA continues to warn that the devices have an increased chance to enter Safety Mode during telemetry or other higher-powered operations. Devices that enter Safety Mode will need to be replaced and Boston Scientific believes approximately 13% of its Accolade pacemakers built before September 2018 face this issue.
- MyOme Launches CAD iPRS: MyOme announced the launch of its Integrated PRS, CAD product (CAD iPRS) that combines whole-genome sequencing data with clinical risk factors for providing better CAD prediction. The CAD iPRS has been validated across multiple gene ancestries and can determine a patient’s ten year absolute risk of developing CAD. MyOme’s test will partner with UPenn in the COMPASS-CAD study to evaluate its predictive abilities for identifying patients who may have been missed or inaccurately assessed by traditional clinical risk assessments.
- Zerlasiran’s Phase 3 Silenced: Despite promising phase 2 data for its ASCVD siRNA drug, zerlasiran, Silence Therapeutics is pumping the brakes on a phase 3 trial due to losing $1.3B in potential funds from its collaboration with Hansoh Pharma. The Chinese pharma giant originally dished out $16M upfront back in 2021 to use Silence’s mRNAi GOLD platform. However, Silence recently revealed that Hansoh has “opted not to pursue further development,” so the company now says it “will only initiate the phase 3 cardiovascular outcomes study once a partner is secured.”
- Willingness to Share Health Data: A recent study in JAMIA showed that consumers fall into three distinct cohorts when it comes to their willingness to share health data. The analysis of Rock Health survey data showed that 15% of respondents were Permissive (broadly willing to share health data), while 48% were Discerning (open to sharing with family or clinicians, but not with companies or researchers). The remaining 37% were Wary, or consistently against sharing data (this group was more likely to be younger and uninsured).
- Robots Impersonating Humans: A state bill introduced in California could prevent AI agents from passing themselves off as human healthcare providers. If signed into law, the legislation would extend regulators’ ability to enforce title protections, which reserve the use of professional job titles for people actually holding those titles (i.e. “nurse” or “doctor”). The bill’s author, Democratic CA State Representative Mia Bonta, said that “generative AI systems are not licensed health professionals, and they shouldn’t be allowed to present themselves as such. It’s a no-brainer to me.”
- Air Pollution’s Link to Cardiac Disease: In a Wednesday morning ECR session, Canadian researchers used cardiac CT scans to find a link between air pollution and cardiovascular disease. The study of 11.1k patients showed that people exposed to high levels of fine particular matter (PM2.5) had higher coronary artery calcium scores, with every 1 µg/m3 increase in 10-year PM2.5 exposure associated with a CAC score 19 points higher. Exposure to nitrogen dioxide (a component of smog) did not produce a statistically significant effect.
- GE Ships Flyrcado PET Tracer: GE HealthCare has delivered the first U.S. doses of its Flyrcado PET radiotracer, which was approved in 2024 for PET myocardial perfusion imaging for patients with known or suspected coronary artery disease. GE is promoting the tracer as an alternative to SPECT MPI and is highlighting its 109-minute half-life, notably longer than other PET tracers. Full commercial shipments will begin in the second quarter, and GE expects to receive CMS pass-through status soon to enable separate Medicare coverage in the outpatient setting.
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CVIS and AI in Structural Heart Treatment
Harnessing the power of CVIS and AI to enhance your heart imaging is crucial in today’s fast-paced health care environment. See how Optum’s CVIS can support clinical workflows and meet the needs of EP and structural heart procedures.
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Cardiology AI: From Research to Clinical Practice
Explore how AI algorithms are reshaping cardiology with insights from Tempus’ recent webinar, featuring Dr. David Ouyang of UCLA and Cedars-Sinai, alongside Tempus’ Dr. John Pfeifer and Dr. Brandon Fornwalt. This expert panel dives into how AI can bridge diagnostic gaps, enhance patient outcomes, and streamline workflows for conditions like AFib and pulmonary hypertension. Read the full recap to glimpse the future of AI-driven cardiology.
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- Making the Leap to Outsource Post-Processing: Interested in how to outsource cardiac image post-processing, but not sure where to start? PIA walks you through how to assess and compare vendors, understand pricing models and payment options, and outline your requirements to identify vendors who meet your clinical needs.
- Connecting the ECG Monitoring Ecosystem: There’s so much that goes into building the solutions that providers use each week, and that’s definitely true for ECG monitoring. In this Cardiac Wire Show interview with Flipside Media’s president Brad Ummer, we get an insider’s view of what it takes to develop an ECG monitoring solution, including Flipside’s partnership with Monebo Technologies.
- Merge Still Best in KLAS: Merge Cardio and Merge Hemo continued their KLAS hot streak, ranking Best in KLAS 2025 for Cardiology and Hemodynamics for the 10th and 13th years. Discover the user enhancements and software improvements that led to Merge Cardio and Merge Hemo’s latest wins.
- Patient Attitudes Towards Us2.ai’s AI-Echo: The medical imaging field is rapidly accepting AI, but how are patients feeling about the shift? Get the scoop on patients’ positive opinions toward Us2.ai’s software that supports task shifting from conventional echo to AI-echo.
- Plaque Analysis Now Covered by Medicare: HeartFlow’s Plaque Analysis is now reimbursable thanks to Medicare’s new coverage for AI-enabled plaque analysis of eligible patients with coronary artery disease.
- Explore Vitrea Advanced Visualization: Discover Canon Medical Healthcare IT’s suite of advanced imaging workflows designed to increase efficiency in cardiovascular imaging, and facilitate the assessment, diagnosis, and treatment of cardiovascular diseases. These cutting-edge tools support the delivery of faster, more accurate care while integrating seamlessly into clinical workflow
- A Better Way to Coordinate Post-Stroke Care: Think your EHR messaging system might be holding back your post-stroke care? See how UC San Diego Medical Center streamlined its neuro and EP teams’ post-stroke workflow with Viz Connect, and the impact it had on cardiac monitor placements in inpatient and outpatient settings.
- Experience the future of learning: Medtronic Academy 2.0 is here! Unlock your ultimate destination for structural heart medical education with the newly redesigned Medtronic Academy 2.0. Gain access to expert-led courses, webinars, and a wealth of resources to stay ahead in cardiovascular care. Visit now!
- Predicting Coronary Events With Plaque Analysis: How can measuring non-calcified plaque burden change how we detect heart disease? Tune-in to Cleerly’s on-demand webinar featuring Sarah Bär, MD, PhD to discover how Cleerly’s AI-powered coronary CTA plaque analysis is reshaping CAD risk prediction, beyond standard tests.
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