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 1.00mg 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±4.2kg in patients with semaglutide and -2.5±1.1kg in control patients (p<0.01). There were also significant declines in the heart failure events, and in all-cause hospitalizations. CONCLUSIONS: Once-weekly 1.00mg 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.