2<\/sup>) and functional limitation (NYHA score II-IV and Kansas City Cardiomyopathy Questionnaire Clinical Summary Score [KCCQ-CCS] <90). Participants were also required to have at least \u22651 of the following: a) elevated filling pressures on invasive measurement, b) elevated natriuretic peptide (NP) levels with associated echocardiographic abnormalities; or c) HF hospitalization in the previous 12 months with ongoing echocardiographic abnormalities on diuretic requirement. Key exclusion criteria included diabetes (HbA1c >6.5%), prior or planned bariatric surgery, >5kg weight fluctuation within the 90 days prior to randomization, CV event <30 days of randomization, or sBP >160 mm Hg. The two primary endpoints were a) change in KCCQ-CSS score over 52 weeks and b) change in body weight over 52 weeks.<\/p>\nA total of 529 patients were 1:1 randomized to either subcutaneous once-weekly semaglutide (2.4mg) or placebo over 52 weeks. \u00a0The median age was 69, and 56% were women. The median BMI was 37 kg\/m2<\/sup>. Participants receiving semaglutide had a significantly greater reduction in KCCQ-CSS over 52 weeks compared to placebo (estimated treatment difference [ETD] 7.8 points, 95% CI 4.8-10.9 points, p<0.001). Participants receiving semaglutide also experienced significantly greater reduction in body weight over 52 weeks compared to placebo (ETD 10.7% body weight reduction, 95% CI 9.4%-11.9% reduction, p<0.001). Secondary endpoints included change in 6MWD at 52 weeks from baseline, which was also increased in the semaglutide group (ETD 20.3 meters, 95% CI 8.6-32.1 meters, p<0.001). Semaglutide users also had a higher win-ratio in the hierarchical composite endpoint of clinical benefit, time to death, number of HF events, time to first HF event, change in KCCQ-CSS, and change in 6MWD (stratified win ratio 1.72, 95% CI 1.37-2.15, p<0.001). Semaglutide also resulted in significant reduction in CRP (43.5% reduction, treatment ratio 0.61) and NT-proBNP (20.9% reduction, treatment ratio 0.84) relative to placebo. Semaglutide was generally well-tolerated, with 13.3% of participants experiencing adverse effects leading to discontinuation, of which 9.5% were gastrointestinal. There were fewer adverse events in the semaglutide group relative to placebo (13.3% vs 26.7%, p<0.001).<\/p>\nWhen discussing the clinical implications of the study at the ESC Congress press conference, Dr. Kosiborod stated: \u201cI think that this study should change the conversation\u2026it is very clear based on these results that in patients with HFpEF, obesity is not just a comorbidity\u2014it appears to be the root cause of heart failure development and progression, and it should be treated as such and should be a target for intervention.\u201d<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
Key Points: More than 80% of patients with HFpEF are overweight or obese, but there has not yet been a study examining the use of weight-loss agents in body weight reduction or HF symptomatology in HFpEF. In the Step-HFpEF study, subcutaneous once-weekly semaglutide was compared with placebo in patients with HFpEF and obesity. The two […]<\/p>\n","protected":false},"author":40603,"featured_media":137988,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[881,8],"tags":[45,882,47,185],"ppma_author":[1029],"class_list":{"0":"post-137999","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-esc-2023","8":"category-news","9":"tag-conference","10":"tag-esc-2023","11":"tag-featured","12":"tag-news","13":"author-leah-kosyakovsky"},"authors":[{"term_id":1029,"user_id":40603,"is_guest":0,"slug":"leah-kosyakovsky","display_name":"Leah Kosyakovsky","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/864bde69f6f1f80e91e4a97f0a0ba8daa64c2bb702be09ed787444c7dfa045bb?s=96&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/137999","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/40603"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=137999"}],"version-history":[{"count":1,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/137999\/revisions"}],"predecessor-version":[{"id":138000,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/137999\/revisions\/138000"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/media\/137988"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=137999"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=137999"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=137999"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=137999"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}