In STEP-HFpEF, a prospective, randomized study of adults with HFpEF and obesity, weekly semaglutide weight-loss injections for 1 year led to substantial improvements in physical function and symptoms.
The STEP-HFpEF and SELECT results will trigger a"a paradigm shift" for cardiologists, who will now need to consider prescribing a weight-loss medication to many of their patients, agents that until now were not part of the usual pharmacologic toolbox for cardiologists, said Kosiborod, a cardiologist and codirector of the Haverty Cardiometabolic Center of Excellence at Saint Luke’s Mid America Heart Institute in Kansas City, Missouri.
Other experts agreed, especially because the STEP-HFpEF results confirmed that weight-loss treatment with semaglutide was safe in this population.The new findings are"a terrific win and game changer for patients with HFpEF," commented Gregg C. Fonarow, MD, professor and co-chief of cardiology at the University of California, Los Angeles, who was not involved with the study.
But Kosiborod said that the improvement seen in the KCCQ score was itself an important benefit for patients."Heart failure is defined clinically based on symptoms," he noted, and results in prior studies documented that patients value improvements in symptoms and physical limitations even more than they value"hard endpoints" such as survival.
And"the SELECT data mean that cardiologists will need to become comfortable prescribing GLP-1 receptor agonists," she added.
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