By Prof Antoni Martínez Rubio, MD, PhD, MsHM, FESC, FACC
Director of Dept. of Cardiology
Hosp. of Sabadell (Univ. Autonoma of Barcelona) Spain
The glucagon-like peptide-1 receptor agonist, semaglutide, at a weight-management dose of 2.4 mg once weekly, improved health status and reduced body weight in patients with obesity-related heart failure (HF) with preserved ejection fraction (HFpEF) in the STEP-HFpEF (Semaglutide Treatment Effect in People with Obesity and HFpEF) program (1,2).
Recently, a prespecified secondary analysis of pooled data from 2 double-blind, placebo-controlled, randomized trials tested the effects of semaglutide in 1.145 patients with obesity-related HFpEF (3). The main outcomes were change in NT-proBNP at 52 weeks and change in the dual primary endpoints of Kansas City Cardiomyopathy Questionnaire Clinical Summary Score and body weight by baseline NT-proBNP.
Semaglutide compared with placebo reduced NT-proBNP at 52 weeks (estimated treatment ratio: 0.82; 95% CI: 0.74-0.91; P . 0.0002). Those participants with higher baseline NT-proBNP had a similar degree of weight loss but experienced larger reductions in HF-related symptoms and physical limitations with semaglutide than those with lower NT-proBNP.
Thus, these results suggest disease-modifying effects of semaglutide and support outcome trials of incretin-based therapies in HFpEF.
References:
- Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023;389:1069-1084.
- Kosiborod MN, Petrie MC, Borlaug BA, et al. Semaglutide in patients with obesity-related heart failure with preserved ejection fraction and type 2 diabetes. N Engl J Med. 2024;390(15):1394–1407.
- Petrie MC, Borlaug BA, Butler J, Davies MJ, Kitzman DW, et al. Semaglutide and NT-proBNP in obesity-related HFpEF. J Am Coll Cardiol 2024; 84:27-40.