Publications by authors named "Brinker M"
Background: An initial decline in estimated glomerular filtration rate (eGFR) often leads to reluctance to continue life-saving therapies in patients with heart failure (HF).
Objectives: The goal of this study was to describe the association between initial decline in eGFR and subsequent clinical outcomes in patients randomized to placebo or finerenone.
Methods: In this prespecified analysis of FINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure), we examined the association between initial decline in eGFR (≥15%) from randomization to 1 month and subsequent outcomes in patients assigned to finerenone or placebo.
Background: Chronic kidney disease (CKD) is a global health problem, affecting over 840 million individuals. CKD is linked to higher mortality and morbidity, partially mediated by higher cardiovascular risk and worsening kidney function. This study aimed to identify risk factors and develop risk prediction models for selected cardiorenal clinical outcomes in patients with non-diabetic CKD.
View Article and Find Full Text PDFBackground: Finerenone has kidney-protective effects in patients with chronic kidney disease with type 2 diabetes, but effects on kidney outcomes in patients with heart failure with and without diabetes and/or chronic kidney disease are not known.
Objectives: The purpose of this study was to examine the effects of finerenone on kidney outcomes in FINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients With Heart Failure), a randomized trial of finerenone vs placebo among patients with heart failure with mildly reduced or preserved ejection fraction.
Methods: We explored the effects of finerenone on the secondary outcome of a sustained ≥50% estimated glomerular filtration rate (eGFR) decline or kidney failure (sustained eGFR decline <15 mL/min/1.
Article Synopsis
- Patients with heart failure (HF) experience increased risks of health complications, but medications like SGLT2 inhibitors (SGLT2i) and finerenone can help reduce cardiovascular events.
- A study called FINEARTS-HF examined the effects of finerenone in patients with HF and varying ejection fractions, especially looking at those already using SGLT2i.
- Results showed finerenone effectively lowered the primary health risks in patients regardless of whether they were on SGLT2i, indicating that these treatments can be beneficial together.
Article Synopsis
- Left ventricular hypertrophy (LVH) is linked to higher risks of cardiovascular disease and mortality, particularly in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) who commonly experience hypertension and LVH.
- This pooled analysis from the FIDELITY studies aimed to investigate the effects of the drug finerenone, a nonsteroidal mineralocorticoid receptor antagonist, on cardiovascular and kidney health in CKD and T2D patients, those with and without baseline LVH.
- Results indicated that while finerenone significantly reduced the risk of heart failure hospitalization in patients with LVH compared to those without, its overall impact on cardiovascular and kidney outcomes was not significantly different based on baseline LV
Article Synopsis
- Cardiovascular-kidney-metabolic syndrome links heart disease, chronic kidney disease, and diabetes, with finerenone being a key treatment studied in three clinical trials: FIDELIO-DKD, FIGARO-DKD, and FINEARTS-HF.
- A pooled analysis of these trials involved nearly 19,000 participants and looked at outcomes over an average follow-up of 2.9 years, showing finerenone reduced overall mortality and hospitalization for heart failure.
- Although the reduction in cardiovascular death wasn't statistically significant, finerenone effectively lower the risk of deaths from any cause, cardiovascular events, and adverse kidney outcomes.
Article Synopsis
- * A study analyzed ED visits from 2015-2022 for patients aged 65 and older, finding that 1.4% experienced chemical sedation and 3.7% physical restraints, with increased likelihood in older age groups and minoritized populations.
- * The findings highlight the concerning rates of restraint use among older adults, especially among historically marginalized groups, suggesting a need for more research on managing agitation in these populations.
Gender representation trends in cardiothoracic surgery journal editorial boards.
J Thorac Cardiovasc Surg
December 2024
Objective: We aimed to characterize chronologic trends of gender composition of the editorial boards of major cardiothoracic surgery journals in the current era.
Methods: A cross-sectional analysis was performed of gender representation in editorial board members of 2 North American cardiothoracic surgery journals from 2008 to 2023. Member names and roles were collected from available monthly issues.
Article Synopsis
- Finerenone, a non-steroidal mineralocorticoid receptor antagonist, showed promise in improving kidney and cardiovascular health in patients with chronic kidney disease (CKD) and type 2 diabetes, leading to the FIND-CKD study examining its effects in non-diabetic patients with CKD.
- The FIND-CKD trial is a Phase 3, randomized, double-blind study involving adults with specific eGFR and urinary albumin-creatinine ratio criteria, focused on the efficacy of finerenone versus a placebo over 32 months.
- The trial screened over 3,200 patients, with 1,584 participating; the majority had chronic glomerulonephritis or hypertensive nephrop
Objectives: This study aimed to evaluate the efficacy and safety of finerenone, a selective, non-steroidal mineralocorticoid receptor antagonist, on cardiovascular and kidney outcomes by age and/or sex.
Design: FIDELITY post hoc analysis; median follow-up of 3 years.
Setting: FIDELITY: a prespecified analysis of the FIDELIO-DKD and FIGARO-DKD trials.
Article Synopsis
- Tic disorders, like Tourette Syndrome, involve uncontrollable movements or sounds that can make everyday life difficult.
- Researchers are using videos to measure these tics better than with just questionnaires, which is becoming more common because it’s easy to get videos from patients.
- The paper shares important tips for using video methods in tic research, ensuring that they are done correctly and ethically based on over 15 years of study.
Importance: Black patients are more likely than White patients to be restrained during behavioral crises in emergency departments (EDs). Although the perils of policing mental health for Black individuals are recognized, it is unclear whether or to what extent police transport mediates the association between Black race and use of physical restraint in EDs.
Objective: To evaluate the degree to which police transport mediates the association between Black race and use of physical restraint in EDs.
Introduction: The burden of mental health-related visits to emergency departments (EDs) is growing, and agitation episodes are prevalent with such visits. Best practice guidance from experts recommends early assessment of at-risk populations and pre-emptive intervention using de-escalation techniques to prevent agitation. Time pressure, fluctuating work demands, and other systems-related factors pose challenges to efficient decision-making and adoption of best practice recommendations during an unfolding behavioural crisis.
View Article and Find Full Text PDFFractures of the tibia and femur are common. Rotation of the limb can affect the outcome of the injury, both in the immediate term and the long term. Because plain radiographs are two dimensional, rotation is hard to assess radiographically.
View Article and Find Full Text PDFRationale & Objective: In FIDELITY, finerenone improved cardiorenal outcomes in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D). This analysis explored the efficacy and safety of finerenone in Black patients.
Study Design: Subanalysis of randomized controlled trials.
Background: Acute kidney injury (AKI) is a common complication after major surgery. This study assessed the risk of developing or worsening of chronic kidney disease (CKD) and other clinical outcomes in patients experiencing AKI after major surgery.
Methods: This retrospective observational study used Optum's de-identified Clinformatics Data Mart Database to investigate cardiorenal outcomes in adult patients at the first AKI event following major surgery.
Aims: To perform dose-exposure-response analyses to determine the effects of finerenone doses.
Materials And Methods: Two randomized, double-blind, placebo-controlled phase 3 trials enrolling 13 026 randomized participants with type 2 diabetes (T2D) from global sites, each with an estimated glomerular filtration rate (eGFR) of 25 to 90 mL/min/1.73 m , a urine albumin-creatinine ratio (UACR) of 30 to 5000 mg/g, and serum potassium ≤ 4.
Significance Statement: The established composite kidney end point in clinical trials combines clinical events with sustained large changes in GFR but does not weigh the relative clinical importance of the end point components. By contrast, a hierarchical composite end point (HCE) accounts for the clinical importance of the end point components. The authors developed and validated a kidney HCE that combines clinical kidney outcomes with longitudinal GFR changes (GFR slope).
View Article and Find Full Text PDFClinical trials in nephrology often use composite end points comprising clinical events, such as onset of ESKD and initiation of kidney function replacement therapy, along with a sustained large ( e.g. , ≥50%) decrease in GFR.
View Article and Find Full Text PDFBackground: Patients with stage 4 CKD and type 2 diabetes have limited treatment options to reduce their persistent cardiovascular and kidney risk. In Finerenone in Chronic Kidney Disease and Type 2 Diabetes (FIDELITY), a prespecified pooled analysis of Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease (FIDELIO-DKD) and Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD), finerenone improved heart-kidney outcomes in participants with CKD and type 2 diabetes.
Methods: This FIDELITY subgroup analysis investigated the effects of finerenone in participants with stage 4 CKD (eGFR <30 ml/min per 1.
Many biological materials exhibit a multiscale porosity with small, mostly nanoscale pores as well as large, macroscopic capillaries to simultaneously achieve optimized mass transport capabilities and lightweight structures with large inner surfaces. Realizing such a hierarchical porosity in artificial materials necessitates often sophisticated and expensive top-down processing that limits scalability. Here, an approach that combines self-organized porosity based on metal-assisted chemical etching (MACE) with photolithographically induced macroporosity for the synthesis of single-crystalline silicon with a bimodal pore-size distribution is presented, i.
View Article and Find Full Text PDFAim: To evaluate the effect of finerenone by baseline HbA1c, HbA1c variability, diabetes duration and baseline insulin use on cardiorenal outcomes and diabetes progression.
Materials And Methods: Composite efficacy outcomes included cardiovascular (cardiovascular death, non-fatal myocardial infarction, non-fatal stroke or hospitalization for heart failure), kidney (kidney failure, sustained ≥ 57% estimated glomerular filtration rate decline or renal death) and diabetes progression (new insulin initiation, increase in antidiabetic medication, 1.0% increase in HbA1c from baseline, new diabetic ketoacidosis diagnosis or uncontrolled diabetes).
Finerenone and effects on mortality in chronic kidney disease and type 2 diabetes: a FIDELITY analysis.
Eur Heart J Cardiovasc Pharmacother
February 2023
Aims: Finerenone reduces the risk of cardiovascular events in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D). We investigated the causes of mortality in the FIDELITY population.
Methods And Results: The FIDELITY prespecified pooled data analysis from FIDELIO-DKD and FIGARO-DKD excluded patients with heart failure and reduced ejection fraction.