Heart failure & cardiomyopathiesSecondary analysis

Inflammation in Obesity-Related heart failure with preserved ejection fraction (HFpEF)

J Am Coll CardiolPublished

  • Secondary analysis of the STEP-HFpEF and STEP-HFpEF DM randomised trials
  • pooled
  • double-blind
  • placebo-controlled
  • international

Authors' conclusion

Inflammation is highly prevalent in obesity-related HFpEF. Semaglutide consistently improved HF-related symptoms, physical limitations, and exercise function, and reduced body weight across the categories of baseline CRP. Semaglutide also reduced inflammation, regardless of either baseline CRP or magnitude of weight loss during the trials.

Study context

Population
Patients with obesity-related HFpEF
Participants
1,145 patients · 2 pooled RCTs
Comparison
Semaglutide 2.4 mg weekly vs placebo, by baseline C-reactive protein (CRP)
Primary endpoint
Change in dual primary endpoints (KCCQ-CSS and body weight) according to baseline CRP
Follow-up
52 weeks

Primary result

As reported in the abstract

Semaglutide effect on KCCQ-CSS and body weight by baseline CRP category

Semaglutide vs placebo reduced HF-related symptoms and physical limitations and body weight, consistent across baseline CRP categories

all P interaction nonsignificant

Prevalence of inflammation (CRP ≥2 mg/L)

71%

Further findings

6MWD and hierarchical composite endpoint, by baseline CRP

Improvements with semaglutide consistent across baseline CRP categories
all P interaction nonsignificant

CRP change

Semaglutide reduced CRP more than placebo regardless of baseline CRP
P for interaction = 0.32

CRP change by magnitude of weight loss · 52 weeks

Change in CRP similar regardless of magnitude of weight loss
P for interaction = 0.91

Baseline characteristics by inflammation level

Higher inflammation: younger, more often female, higher BMI, worse Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score (KCCQ-CSS), shorter 6MWD

Original publication

Inflammation in Obesity-Related HFpEF. J Am Coll Cardiol. Published 30 August 2024. doi:10.1016/j.jacc.2024.08.028

Summarised from the published abstract; every number is checked against it