Semaglutide in HFpEF across obesity class and by body weight reduction: a prespecified analysis of the STEP-HFpEF trial
Por:
Borlaug B, Kitzman D, Davies M, Rasmussen S, Barros E, Butler J, Einfeldt M, Hovingh G, Moller D, Petrie M, Shah S, Verma S, Abhayaratna W, Ahmed F, Chopra V, Ezekowitz J, Fu M, Ito H, Lelonek M, Melenovsky V, Nunez J, Perna E, Schou M, Senni M, van der Meer P, Von Lewinski D, Wolf D, Kosiborod M
Publicada:
1 sep 2023
Ahead of Print:
1 ago 2023
Resumen:
In the STEP-HFpEF trial, semaglutide improved symptoms, physical limitations and exercise function and reduced body weight in patients with obesity phenotype of heart failure and preserved ejection fraction (HFpEF). This prespecified analysis examined the effects of semaglutide on dual primary endpoints (change in Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score (KCCQ-CSS) and body weight) and confirmatory secondary endpoints (change in 6-minute walk distance (6MWD), hierarchical composite (death, HF events, change in KCCQ-CSS and 6MWD) and change in C-reactive protein (CRP)) across obesity classes I-III (body mass index (BMI) 30.0-34.9 kg m-2, 35.0-39.9 kg m-2 and & GE;40 kg m-2) and according to body weight reduction with semaglutide after 52 weeks. Semaglutide consistently improved all outcomes across obesity categories (P value for treatment effects x BMI interactions = not significant for all). In semaglutide-treated patients, improvements in KCCQ-CSS, 6MWD and CRP were greater with larger body weight reduction (for example, 6.4-point (95% confidence interval (CI): 4.1, 8.8) and 14.4-m (95% CI: 5.5, 23.3) improvements in KCCQ-CSS and 6MWD for each 10% body weight reduction). In participants with obesity phenotype of HFpEF, semaglutide improved symptoms, physical limitations and exercise function and reduced inflammation and body weight across obesity categories. In semaglutide-treated patients, the magnitude of benefit was directly related to the extent of weight loss. Collectively, these data support semaglutide-mediated weight loss as a key treatment strategy in patients with obesity phenotype of HFpEF. ClinicalTrials.gov identifier: NCT04788511.
In a prespecified secondary analysis of the STEP-HFpEF trial, semagludtide treatment was associated with improvements in KCCQ-CSS and body weight, as well as trial secondary endpoints, across the spectrum of obesity classes, with the magnitude of beneficial effects being proportional to the extent of weight loss.
Filiaciones:
Borlaug B:
Mayo Clin, Dept Cardiovasc Med, Rochester, MN USA
Kitzman D:
Wake Forest Univ, Bowman Gray Sch Med, Dept Cardiovasc Med, Winston Salem, NC USA
Wake Forest Univ, Bowman Gray Sch Med, Sect Geriatr & Gerontol, Winston Salem, NC USA
Davies M:
Univ Leicester, Diabet Res Ctr, Leicester, England
NIHR Leicester Biomed Res Ctr, Leicester, England
Rasmussen S:
Novo Nord AS, Soborg, Denmark
Barros E:
Novo Nord AS, Soborg, Denmark
Butler J:
Baylor Scott & White Res Inst, Dallas, TX USA
Univ Mississippi, Dept Med, Jackson, MS USA
Einfeldt M:
Novo Nord AS, Soborg, Denmark
Hovingh G:
Novo Nord AS, Soborg, Denmark
Moller D:
Novo Nord AS, Soborg, Denmark
Petrie M:
Univ Glasgow, Sch Cardiovasc & Metab Hlth, Glasgow, Scotland
Shah S:
Northwestern Univ, Dept Med, Div Cardiol, Feinberg Sch Med, Chicago, IL USA
Verma S:
Univ Toronto, Michaels Hosp, Li Ka Shing Knowledge Inst St, Div Cardiac Surg,Unity Hlth Toronto, Toronto, ON, Canada
Abhayaratna W:
Australian Natl Univ, Coll Hlth & Med, Canberra, ACT, Australia
Ahmed F:
Univ Manchester, Fac Biol Med & Hlth, Div Cardiovasc Sci, Manchester, England
Chopra V:
Max Super Specialty Hosp, Clin Cardiol Heart Failure & Res, New Delhi, India
Ezekowitz J:
Univ Alberta, Edmonton, AB, Canada
Fu M:
Sahlgrens Univ Hosp, Dept Med, Sect Cardiol, Gothenburg, Sweden
Ito H:
Kawasaki Med Sch, Dept Gen Internal Med 3, Okayama, Japan
Lelonek M:
Med Univ Lodz, Dept Noninvas Cardiol, Lodz, Poland
Melenovsky V:
Inst Clin & Expt Med IKEM, Prague, Czech Republic
Nunez J:
Univ Valencia, Hosp Clin Univ Valencia, INCLIVA, Valencia, Spain
CIBER Cardiovasc, Valencia, Spain
Perna E:
Inst Cardiol JF Cabral, Corrientes, Argentina
Schou M:
Univ Copenhagen, Herlev Gentofte Hosp, Dept Cardiol, Herlev, Denmark
Senni M:
ASST Papa Giovanni XXIII Hosp, Cardiovasc Dept, Bergamo, Italy
van der Meer P:
Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands
Von Lewinski D:
Med Univ Graz, Div Cardiol, Graz, Austria
Wolf D:
Univ Freiburg, Fac Med, Med Ctr, Cardiol & Angiol, Freiburg, Germany
Kosiborod M:
Univ Missouri, St Lukes Mid Amer Heart Inst, Sch Med, Dept Cardiovasc Dis, Kansas City, MO 65211 USA
Green Published, hybrid
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