Heart failure & cardiomyopathiesMeta-analysis
Semaglutide and NYHA Functional Class in Obesity-Related Heart Failure With Preserved Ejection Fraction
- Prespecified pooled analysis of the STEP-HFpEF and STEP-HFpEF DM randomised trials
- pooled data from 2 international randomised trials
- double-blind
Authors' conclusion
In patients with obesity-related HFpEF, fewer semaglutide-treated than placebo-treated patients had a deterioration, and more had an improvement, in NYHA functional class at 52 weeks.
Study context
- Population
- Patients with obesity-related heart failure with preserved ejection fraction (HFpEF)
- Participants
- 1,145 patients · 2 RCTs
- Comparison
- Semaglutide 2.4 mg once weekly vs placebo
- Outcome
- Change in NYHA functional class
- Follow-up
- Baseline to 52 weeks
Pooled result
As reported in the abstract
NYHA functional class · 52 weeks
Semaglutide
32.6%
Improvement · Deterioration 2.09%
Placebo
21.5%
Improvement · Deterioration 5.24%
Semaglutide vs PlaceboOdds ratio (95% CI)P value
improvement
2.20(1.62–2.99)
P < 0.001deterioration
0.36(0.19–0.70)
P = 0.003Further pooled results
| Outcome | difference (points) (95% CI) | |
|---|---|---|
| KCCQ-CSS, by baseline NYHA class (subgroup) — Semaglutide vs Placebo · NYHA III/IV | 10.5 (6.6–14.4) | |
| KCCQ-CSS, by baseline NYHA class (subgroup) — Semaglutide vs Placebo · NYHA II | 6.0 (3.4–8.6) | |
| −1001020Difference, points (linear scale) |
| Outcome | difference (95% CI) | |
|---|---|---|
| Bodyweight, by baseline NYHA class (subgroup) — Semaglutide vs Placebo · NYHA II | −8.4% (−9.4% to −7.3%) | |
| Bodyweight, by baseline NYHA class (subgroup) — Semaglutide vs Placebo · NYHA III/IV | −8.3% (−9.9% to −6.8%) | |
| −10−505Difference (linear scale) |
- KCCQ-CSS, by baseline NYHA class (subgroup): P interaction = 0.06
- Bodyweight, by baseline NYHA class (subgroup): P interaction = 0.96
6MWD, hierarchical composite endpoint, CRP, NT-proBNP, by baseline NYHA class
- Semaglutide consistently improved 6MWD and the hierarchical composite endpoint and reduced CRP and NT-proBNP across NYHA class categories
- all P interactions = NS
Original publication
Semaglutide and NYHA Functional Class in Obesity-Related Heart Failure With Preserved Ejection Fraction. J Am Coll Cardiol. Published 23 June 2024. doi:10.1016/j.jacc.2024.04.038
Summarised from the published abstract; every number is checked against it