Heart failure & cardiomyopathiesSecondary analysis
Effect of Semaglutide on Cardiac Structure and Function in Patients With Obesity-Related Heart Failure
- Secondary analysis of the STEP-HFpEF Program randomised trials
- echocardiography substudy
- pooled STEP-HFpEF and STEP-HFpEF DM trials
Authors' conclusion
In the STEP-HFpEF Program echocardiography substudy, semaglutide appeared to improve adverse cardiac remodeling compared with placebo, further suggesting that treatment with semaglutide may be disease modifying among patients with obesity-related HFpEF.
Study context
- Population
- Patients with obesity-related heart failure with preserved ejection fraction (HFpEF) (with or without T2DM)of 1,145 in STEP-HFpEF Program
- Participants
- 491 patients
- Comparison
- Semaglutide 2.4 mg once weekly vs placebo
- Semaglutiden = 253
- Placebon = 238reference
- Primary endpoint
- Change in left atrial volume
- Follow-up
- 52 weeks
Primary result
LA volume
Estimated mean difference
−6.13 mL
95% CI −9.85 to −2.41
P = 0.0013
Semaglutide vs Placebo
estimated mean difference −6.13 mL (95% CI −9.85 to −2.41); P = 0.0013
As reported in the abstract
Secondary outcomes
| Outcome | estimated mean difference (cm²) (95% CI) | P value | |
|---|---|---|---|
| RV end-diastolic area · 52 weeks | −1.99 (−3.60 to −0.38) | P = 0.016 | |
| RV end-systolic area · 52 weeks | −1.41 (−2.42 to −0.40) | P = 0.0064 | |
| −4−202Difference, cm² (linear scale) |
| Outcome | estimated mean difference (cm/s) (95% CI) | P value | |
|---|---|---|---|
| E-wave velocity · 52 weeks | −5.63 (−9.42 to −1.84) | P = 0.0037 | |
| −10−505Difference, cm/s (linear scale) |
| Outcome | estimated mean difference (95% CI) | P value | |
|---|---|---|---|
| E/A ratio · 52 weeks | −0.14 (−0.24 to −0.04) | P = 0.0075 | |
| E/e' average · 52 weeks | −0.79 (−1.60 to 0.01) | P = 0.05 | |
| −2−101Difference (linear scale) |
LV dimensions, mass, systolic function
- Semaglutide did not significantly affect LV dimensions, mass, or systolic function
Modification by diabetes or AF status
- Associations not modified by diabetes or AF status
Weight loss and left atrial (LA) volume reduction
- Greater weight loss with semaglutide associated with greater LA volume reduction; not with changes in E-wave velocity, E/e' average or right ventricular (RV) end-diastolic area
- P for interaction = 0.033
Original publication
Effect of Semaglutide on Cardiac Structure and Function in Patients With Obesity-Related Heart Failure. J Am Coll Cardiol. Published 30 August 2024. doi:10.1016/j.jacc.2024.08.021
Summarised from the published abstract; every number is checked against it