Heart failure & cardiomyopathies
Inflammation in Obesity-Related Heart Failure with Preserved Ejection Fraction (HFpEF): The STEP-HFpEF Program
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
Methodological detailspooled, double-blind, placebo-controlled, international
- Pooled
- Double-blind
- Placebo-controlled
- International
Primary result
As reported in the abstract
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
Summarised from the published abstract; every number is checked against it