Efficacy of once-weekly semaglutide in patients with heart failure with preserved ejection fraction, obesity and type 2 diabetes

Introduction and objectives

There is still limited evidence on the role of glucagon-like peptide-1 receptor agonists in heart failure. We analyzed the efficacy in terms of health status, and the change in body weight of once-weekly semaglutide in patients with heart failure with preserved ejection fraction, obesity and type 2 diabetes.

Patients and methods

This prospective, real-world study included patients with heart heart failure with preserved ejection fraction, obesity and type 2 diabetes treated with once-weekly 1.00 mg semaglutide (Sema-Preserved Group) and patients not treated with glucagon-like peptide-1 receptor agonists (Control-Preserved Group). A 1:1 propensity score matching analysis was performed. The primary outcome was the heart failure status defined as the ≥5 point difference in the Spanish version of the Kansas City Cardiomyopathy Questionnaire total symptom score, and the change of body weight at 24 months.

Results

After matching, 203 patients were included in each group. A primary outcome event occurred in 123 patients (60.6%) in the Sema-Preserved Group and 36 (17.7%) in the Control-Preserved Group (odds ratio: 3.99; 95% confidence interval: 1.69–6.28; p < 0.01), and the mean change in body weight was −12.9 ± 4.2 kg in patients with semaglutide and −2.5 ± 1.1 kg in control patients (p < 0.01). There were also significant declines in the heart failure events, and in all-cause hospitalizations.

Conclusions

Once-weekly 1.00 mg semaglutide was associated with improved heart failure health status, and weight loss in patients with heart failure with preserved ejection fraction, obesity, and type 2 diabetes. Further research on glucagon-like peptide-1 receptor agonists in heart failure is needed.