Semaglutide cuts obesity, improves Heart Failure symptoms in Atrial Fibrillation: JACC
A recent secondary analysis from the pooled data of the STEP-HFpEF
(Heart Failure with Preserved Ejection Fraction) Program and STEP-HFpEF DM
found that once a week’s prescription of Semaglutide 2.4 mg has led to
significant improvements in Heart failure-related symptoms and physical
limitations in individuals with Atrial Fibrillation (AF) at the baseline than
those without AF. Results from this analysis were published in the Journal of
American College of Cardiology.
AF is frequently observed in individuals with HFpEF and
leads to adverse outcomes in these individuals compared to those with normal
sinus rhythm. Obesity is an important risk factor for the development and
progression of HFpEF and AF. Previous research from the HFpEF and HFpEF DM
trials showed that Semaglutide had better results in those with HF-related
symptoms, physical limitations, exercise function, body weight, and
obesity-related heart failure in obesity-related HFpEF. However, there is
uncertainty on the efficacy of semaglutide in individuals with or without AF.
Hence, researchers conducted a secondary analysis from the pooled data of the
two trials to evaluate the baseline characteristics, and clinical
features, of obesity-related HFpEF individuals with and without a history of
AF. They also determined the efficacy of Semaglutide across various types of
AF.
Individuals with heart failure, left ventricular
ejection fraction ≥45%, body mass index ≥30 kg/m2, and Kansas City
Cardiomyopathy Questionnaire–Clinical Summary Score (KCCQ-CSS) <90
points were randomized 1:1 to receive once-weekly semaglutide 2.4 mg or
matching placebo for 52 weeks. The endpoints investigated based on the
investigator-reported history of AF included the following:
Primary – change in KCCQ-CSS and percent change in body
weightConfirmatory
- Secondary – change in 6-minute walk distance,
all-cause death, HF events, thresholds of change in KCCQ-CSS, and 6-minute walk
distance; and C-reactive protein
Exploratory endpoint – change in N-terminal pro–B-type
natriuretic peptide
Based on the presence of AF, the responder analysis examined
the improvements in the KCCQ-CSS score
Findings:
Among 1145 individuals, 45% had a history of AF of different
typesMost of them with AF were older, male, with high levels of
NTproBNP, were among the NYHA functional class III symptoms, and were taking
more antithrombotics, beta-blockers, and diuretics.-
A significant improvement in the KCCQ-CSS score (11.5 vs 4.3
points was seen in the individuals with AF vs without AFA significant proportion of individuals with AF taking
semaglutide reported ≥5-, ≥10-, ≥15-, and ≥20-point improvement in KCCQ-CSS than
without AF and on placebo. -
Apart from these a consistent reduction in the CRP,
NT-proBNP, and body weight was seen despite the AF status with semaglutide.
Thus, the study concluded that semaglutide was effective in
improving HF-related symptoms and obesity-related heart failure with pronounced
improvements in individuals with AF. Semaglutide proves to be a potential drug
for improving heart failure symptoms and obesity in individuals with AF.
improving HF-related symptoms and obesity-related heart failure with pronounced
improvements in individuals with AF. Semaglutide proves to be a potential drug
for improving heart failure symptoms and obesity in individuals with AF.
