Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity

The STEP HFpEF trial investigated the efficacy of semaglutide (2.4 mg weekly) in 529 patients with HFpEF and obesity (BMI ≥30). At 52 weeks, semaglutide significantly improved the dual primary endpoints: Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS; mean difference +7.8 points, 95% CI 4.8–10.9, P<0.001) and body weight (10.7% vs. placebo, P<0.001). Confirmatory secondary endpoints included a 20.3meter greater improvement in 6-minute walk distance (P<0.001), a 1.72 win ratio for the hierarchical composite endpoint (P<0.001), and a 43.5% reduction in C-reactive protein levels (P<0.001). Semaglutide also reduced serious adverse events (13.3% vs. 26.7% with placebo). The study demonstrates semaglutide’s potential to improve symptoms, physical function, and inflammation in HFpEF patients with obesity.

The STEP HFpEF trial investigated the efficacy of semaglutide (2.4 mg weekly) in 529 patients with HFpEF and obesity (BMI ≥30). At 52 weeks, semaglutide significantly improved the dual primary endpoints: Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS; mean difference +7.8 points, 95% CI 4.8–10.9, P<0.001) and body weight (10.7% vs. placebo, P<0.001). Confirmatory secondary endpoints included a 20.3meter greater improvement in 6-minute walk distance (P<0.001), a 1.72 win ratio for the hierarchical composite endpoint (P<0.001), and a 43.5% reduction in C-reactive protein levels (P<0.001). Semaglutide also reduced serious adverse events (13.3% vs. 26.7% with placebo). The study demonstrates semaglutide’s potential to improve symptoms, physical function, and inflammation in HFpEF patients with obesity.