Overview

Chronic heart failure is common and particularly serious when patients also have kidney impairment and have recently experienced a heart failure event. This group has high risks of death and recurrent heart failure events, while current treatment options remain limited.
This study evaluates the efficacy and safety of a new combination regimen: a next-generation mineralocorticoid receptor antagonist (MRA) plus a sodium-glucose co-transporter-2 (SGLT2) inhibitor, compared with SGLT2 inhibitor monotherapy, on top of standard of care. The new combination is expected to reduce side effects while maintaining treatment efficacy, thereby improving disease control and reducing cardiovascular complications and mortality in patients with chronic heart failure and chronic kidney disease.

Inclusion Criteria

Men and women aged ≥18 years
Symptomatic heart failure (NYHA class II–IV), with at least one recent heart failure event within the past 6 months (hospitalization or emergency visit for heart failure, or current hospitalization for worsening chronic heart failure)
Estimated glomerular filtration rate (eGFR) ≥20 to <60 mL/min/1.73 m²
On treatment for heart failure and kidney disease, but not taking mineralocorticoid receptor antagonists (MRAs) such as spironolactone, eplerenone, finerenone, etc.

Exclusion Criteria

Systolic blood pressure <100 mmHg, or symptomatic hypotension
Systolic blood pressure ≥160 mmHg while taking fewer than 3 antihypertensive drugs, or ≥180 mmHg regardless of treatment
Hepatitis B or hepatitis C
Use of an MRA for more than 7 days in the past month, or planned MRA therapy
Acute coronary syndrome (unstable angina or myocardial infarction), stroke, or transient ischemic attack within the past 3 months

PI

MSc, MD Dương Thu Anh – Cardiology Center, Vinmec Times City Internation Hospital