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Panelists discuss how nonsteroidal MRAs like finerenone differ mechanistically from steroidal MRAs by lacking steroid rings (reducing steroid-related adverse effects like gynecomastia), having different mineralocorticoid receptor binding patterns, shorter half-lives, and potentially lower hyperkalemia risk, with strong evidence supporting their use in heart failure with preserved ejection fraction and additive benefits when combined with SGLT2 inhibitors.

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