Initiating Mineralocorticoid Antagonists for Longstanding Heart Failure With Reduced Ejection Fraction: Better Late Than Never?

Competing Interests: Funding Support and Author Disclosures Dr Sauer has received salary support for research activities from Saint Luke’s Mid America Heart Institute, a nonprofit academic research organization affiliated with the University of Missouri—Kansas City that receives or has received funding from Bayer, CSL Vifor, Pfizer, Rivus, AstraZeneca, Abbott, Boston Scientific, General Prognostics, Acorai, Story Health, and Amgen; and has received honoraria for speaking or advising for Bayer, CSL Vifor, Abbott, Impulse Dynamics, Boston Scientific, Edwards Lifesciences, Acorai, Story Health, and General Prognostics. Dr Hsia has received salary support from CPC, a nonprofit academic research organization affiliated with the University of Colorado that receives or has received research grant and consulting funding since 2021 from Abbott Laboratories, Adamis Pharmaceuticals Corporation, Agios Pharmaceuticals, Alexion Pharma, Alnylam Pharmaceuticals, Amgen, Angionetics, ARCA Biopharma, Array BioPharma, AstraZeneca and Affiliates, Atentiv, Audentes Therapeutics, Bayer and Affiliates, Beth Israel Deaconess Medical Center, Better Therapeutics, BIDMC, Boston Clinical Research Institute, Bristol Myers Squibb, Cambrian Biopharma, Cardiol Therapeutics, CellResearch, Cleerly, Cook Medical, Covance, CSL Behring, Eidos Therapeutics, EP Trading Co, EPG Communication Holdings, Epizon Pharma, Esperion Therapeutics, Everly Well, Exicon Consulting, Faraday Pharmaceuticals, Foresee Pharmaceuticals, Fortress Biotech, HDL Therapeutics, HeartFlow, Hummingbird Bioscience, Insmed, Ionis Pharmaceuticals, IQVIA, JanOne Biotech Holdings, Janssen and Affiliates, Kaneka, Kowa Research Institute, Kyushu University, Lexicon Pharmaceuticals, LSG Kyushu University, Medimmune, Medpace, Merck and Affiliates, Novartis Pharmaceuticals, Novate Medical, Novo Nordisk, Pan Industry Group, Pfizer, PhaseBio Pharmaceuticals, PPD Development, Prairie Education and Research Cooperative, Prothena Biosciences, Regeneron Pharmaceuticals, Regio Biosciences, Regeneron, Sanifit Therapeutics Sanofi-Aventis Groupe, Silence Therapeutics, Smith and Nephew, Stealth BioTherapeutics, State of Colorado CCPD Grant, Brigham and Women’s Hospital, Feinstein Institutes for Medical Research, Thrombosis Research Institute, University of Colorado, University of Pittsburgh, VarmX, Virta Health, WCT Atlas, Worldwide Clinical Trials, WraSer, and Yale Cardiovascular Research Group; and owns stock in AstraZeneca.