A Study to Determine the Efficacy and Safety of Finerenone on Morbidity and Mortality Among Hospitalized Heart Failure Patients

Inclusion Criteria:

• Provide electronic or written informed consent, either personally or through a legallyauthorized representative
• Age ≥18 years
• Current hospitalization or recently discharged with the primary diagnosis of heartfailure
• Heart failure signs and symptoms at the time of hospital admission
• Imaging evidence of mildly reduced or preserved left ventricular ejection fraction (EF) (40% or higher)
• Elevated N-terminal pro B-type natriuretic peptide (NTproBNP) ≥1000 pg/mL or B-typenatriuretic peptide (BNP) ≥250 pg/mL for patients without atrial fibrillation (AF); orelevated NTproBNP ≥2000 pg/mL or BNP ≥500 pg/mL for patients with AF

Exclusion Criteria:

• Treatment with a mineralocorticoid receptor antagonist (MRA)
• Documented prior history of severe hyperkalemia in the setting of MRA use
• Estimated glomerular filtration rate (eGFR) <25 mL/min/1.73m² or serum/plasmapotassium >5.0 mmol/L at screening
• Acute myocardial infarction, coronary revascularization, valve replacement/repair, orimplantation of a cardiac resynchronization therapy device within 30 days
• Hemodynamically significant (severe) uncorrected primary cardiac valvular disease
• Cardiomyopathy due to known acute inflammatory heart, infiltrative diseases,accumulation diseases, muscular dystrophies, cardiomyopathy with reversible causes,known hypertrophic obstructive cardiomyopathy, complex congenital heart disease, orknown pericardial constriction
• Probable alternative cause of participant's heart failure symptoms
• Concomitant systemic therapy with potent cytochrome P450 isoenzyme 3A4 (CYP3A4)inhibitors or moderate CYP3A4 inducers, or potent CYP3A4 inducers