Description 
A prespecified FINE‑HEART analysis of 18,991 adults—published online in JACC—examined sudden death across CKM stages and found that finerenone reduced the risk of sudden death by 19% versus placebo over a median 2.9 years, preventing one sudden death per 216 patients treated. Sudden death accounted for 47% of cardiovascular deaths (418 events), highlighting a large arrhythmic component of mortality in CKM syndrome. Risk was strongly stage‑dependent: patients with CKM Stage 4 faced a 2.7‑fold higher sudden‑death risk than those in Stages 2–3. Readily available clinical predictors (older age, prior heart failure or myocardial infarction, atrial fibrillation, higher UACR, lower systolic blood pressure, and reduced eGFR) identified high‑risk individuals without new testing. Practical dosing in the trials started at 10–20 mg once daily, titrated by eGFR. The stage‑specific findings support targeting intensive monitoring and finerenone therapy to those most likely to benefit and add weight to guideline recommendations for finerenone in combined cardiorenal risk.