#ACC24 Semaglutide improves quality of life in patients with heart failure with preserved ejection fraction, diabetes and obesity

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Heart failure with preserved ejection fraction is a complex condition associated with an increased risk of morbidity and mortality among obese patients with type 2 diabetes.

The study STEP-HfpEF DMpresented during the Annual Meeting of American College of Cardiology from 2024, reported o significant weight loss and improved quality of life obese patients (BMI ≥30 kg/m²) And with type 2 diabetes, suffering from heart failure with preserved ejection fraction (FE ≥45%), under treatment with semaglutide (trade name Wegovy).

The study included 616 patientsof which 310 had treatment with subcutaneously administered semaglutide for 52 weeks, and 306 received placebo. Doses of semaglutide started at 0.25mg, gradually increasing to a maintenance dose of 2.4mg.

The main results were:

• Improvement of symptoms, according to the KCCQ-CSS score (Kansas City Cardiomyopathy Questionnaire): 13.7 point improvement for patients receiving semaglutide versus 6.4 points for placebo.
• BMI decrease by 9.8% in the semaglutide-treated group, versus 3.4% for the control group.
• 12.7 meter increase in distance traveled in the 6-minute walk test of patients on semaglutide compared to a loss of 1.6 meters walked in the control group.
• NT-proBNP decrease by 23.2% for the semaglutide group compared to 4.6% for placebo.

Dr. Mikhail Kosiborod, principal investigator of the study, emphasizes, in an interview with TCTMD, the importance of these results, highlighting that the benefits observed in the study are comparable to those obtained in other previous studies. STEP-HfpEF DM complements the results of a similar study, presented in 2023, which showed the benefits of semaglutide in heart failure patients with preserved ejection fraction and obesity but without diabetes. Researchers assume that benefits of semaglutide, independent of weight loss, may include direct effects on vascular function, muscle function, inflammation, and insulin resistance.

The results of the study showed that patients treated with semaglutide recorded significant improvements in clinical scores and six-minute walk distance compared to placebo-treated patients. This suggests that semaglutide may have benefits in symptom improvement heart failure with preserved ejection fraction. Additional data are needed to confirm the results and to fully understand the mechanisms by which semaglutide works.

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