Evidence map›GLP-1 receptor agonists × cardiac & vascular function›PMID 38819334›Full record

Trial reportJournal of the American College of Cardiology2024

Semaglutide and NT-proBNP in Obesity-Related HFpEF: Insights From the STEP-HFpEF Program.

Mark C Petrie, Barry A Borlaug, Javed Butler, Melanie J Davies, Dalane W Kitzman, Sanjiv J Shah, Subodh Verma, Thomas Jon Jensen, Mette Nygaard Einfeldt, Karoline Liisberg and 9 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
PubMed Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2024. The graph read 1 number from its abstract, feeding 1 cell of the map: it favours the comparator in 1. It is linked to trial NCT07738276 (Evaluation of the Efficacy and Safety of Tirzepatide, a Dual GLP-1/GIP Agonist, on Functional Capacity in Reduced Ejection Fraction Heart Failure Patients With Obesity), which is not on this map. Cited by 41 papers, 3 of them syntheses that pooled it.

1number the graph read from it
1cell of the map it votes in
41citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
8.200 · no effect
Cardiac & vascular functionfavours the comparator · against placebo · heart_failure, obesityfeeds one cell of the map
Δ 4.500.80 to 8.20
Improvements in health status were more pronounced in those with higher vs lower baseline NT-proBNP (estimated difference: tertile 1: 4.5 points, 95% CI: 0.8-8.2; tertile 2: 6.2 points, 95% CI: 2.4-10.0; tertile 3: 11.9 points, 95% CI: 8.1-15.7; P interaction = 0.02; baseline NT-proBNP as a continuous variable: P interaction = 0.004).
FeedsGLP-1 receptor agonists×cardiac & vascular function

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GLP-1 receptor agonists×cardiac & vascular function

ContradictsOpen on the map →What to test next →

6 readable studies in this cell: 3 favour the treatment, 2 find no difference, 1 favour the comparator.

Belief with this paper
0.50contested · 3 families support, 1 contradict · against placebo
Without it
1.00This paper moves it by −0.50. It would be replicated.
← favours the treatmentfavours the comparator →
0 · no effect
This paper · 2024
Δ 4.500.80 to 8.20
Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 …PMID 38587233 · 617 enrolled · 2021
change 0.670.55 to 0.80
NCT04788511529 enrolled · 2021
Δ 7.804.80 to 10.9
NCT0488111060 enrolled · 2021
Δ 25.121.8 to 28.3
Effect of liraglutide on cardiac function in patients with type 2 diab…PMID 31039778 · 50 enrolled · 2013
Δ 1.00
Effect of liraglutide, a glucagon-like peptide-1 analogue, on left ven…PMID 27790809 · 2017
Δ -0.80-2.10 to 0.50
4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07738276 phase3not yet recruitingstarted 2026, after this paper: background citation

Evaluation of the Efficacy and Safety of Tirzepatide, a Dual GLP-1/GIP Agonist, on Functional Capacity in Reduced Ejection Fraction Heart Failure Patients With Obesity: A Double-Blinded Randomized Controlled Trial

Ran2026Enrolled60Registered outcomes27Posted comparisons0ConditionsHeart Failure and Reduced Ejection Fraction, Obesity & Overweight, TirzepatideArmsPlacebo, Tirzepatide
PMID 37622681PMID 39555826PMID 37932236PMID 37952180PMID 38632048PMID 18159244PMID 39551891PMID 34811547PMID 39556714PMID 3283935PMID 18193044other papers from this trial
Open the trial in the graph
5 · Its place in the literature

Who cites it

41 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Trial
  6. Trial
  7. Trial
  8. Review
  9. Review
  10. Wearable Flexible Sensors for Cardiovascular Disease Monitoring.Advanced materials (Deerfield Beach, Fla.) · 2026
    Review
  11. Review
  12. Review
  13. Review
  14. Article
  15. Review
  16. Review
  17. Article
  18. Review
  19. Observational
  20. Review
6 · The record

Corrections and comments

7 · Who and what money

Authors and funding

19 authors.

Mark C PetrieSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom.
Barry A BorlaugDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Javed ButlerBaylor Scott and White Research Institute, Dallas, Texas, USA; Department of Medicine, University of Mississippi, Jackson, Mississippi, USA.
Melanie J DaviesDiabetes Research Centre, University of Leicester, Leicester, United Kingdom; NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom.
Dalane W KitzmanDepartment of Cardiovascular Medicine and Section on Geriatrics and Gerontology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Sanjiv J ShahDivision of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Subodh VermaDivision of Cardiac Surgery, Li Ka Shing Knowledge Institute of St Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Ontario, Canada.
Thomas Jon JensenNovo Nordisk A/S, Søborg, Denmark.
Mette Nygaard EinfeldtNovo Nordisk A/S, Søborg, Denmark.
Karoline LiisbergNovo Nordisk A/S, Søborg, Denmark.
Eduardo PernaInstituto de Cardiología de Corrientes J. F. Cabral, Corrientes, Argentina.
Kavita SharmaDivision of Cardiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Justin A EzekowitzUniversity of Alberta, Edmonton, Alberta, Canada.
Michael FuSection of Cardiology, Department of Medicine, Sahlgrenska University Hospital-Ostra, Gothenburg, Sweden.
Vojtěch MelenovskýInstitute for Clinical and Experimental Medicine, Prague, Czech Republic.
Hiroshi ItoDepartment of General Internal Medicine 3, Kawasaki Medical School, Okayama, Japan.
Małgorzata LelonekDepartment of Noninvasive Cardiology, Medical University of Lodz, Lodz, Poland.
Mikhail N KosiborodDepartment of Cardiovascular Disease, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA. Electronic address: mkosiborod@saint-lukes.org.
STEP-HFpEF Trial Committees and Investigators

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundThe glucagon-like peptide-1 receptor agonist, semaglutide, improved health status and reduced body weight in patients with obesity-related heart failure (HF) with preserved ejection fraction (HFpEF) in the STEP-HFpEF (Semaglutide Treatment Effect in People with Obesity and HFpEF) program. Whether benefits were due to mechanical unloading or effects on HF pathobiology is uncertain.

objectivesThis study sought to determine if semaglutide 2.4 mg reduced N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with obesity-related HFpEF and compare treatment responses by baseline NT-proBNP.

methodsThis was a prespecified secondary analysis of pooled data from 2 double-blind, placebo-controlled, randomized trials (STEP-HFpEF [Research Study to Investigate How Well Semaglutide Works in People Living With Heart Failure and Obesity] and STEP-HFpEF DM [Research Study to Look at How Well Semaglutide Works in People Living With Heart Failure, Obesity and Type 2 Diabetes]) testing effects of semaglutide in patients with obesity-related HFpEF. The main outcomes were change in NT-proBNP at 52 weeks and change in the dual primary endpoints of Kansas City Cardiomyopathy Questionnaire Clinical Summary Score and body weight by baseline NT-proBNP.

resultsIn total, 1,145 patients were randomized. Semaglutide compared with placebo reduced NT-proBNP at 52 weeks (estimated treatment ratio: 0.82; 95% CI: 0.74-0.91; P = 0.0002). Improvements in health status were more pronounced in those with higher vs lower baseline NT-proBNP (estimated difference: tertile 1: 4.5 points, 95% CI: 0.8-8.2; tertile 2: 6.2 points, 95% CI: 2.4-10.0; tertile 3: 11.9 points, 95% CI: 8.1-15.7; P interaction = 0.02; baseline NT-proBNP as a continuous variable: P interaction = 0.004). Reductions in body weight were consistent across baseline NT-proBNP levels (P interaction = 0.21).

conclusionsIn patients with obesity-related HFpEF, semaglutide reduced NT-proBNP. Participants with higher baseline NT-proBNP had a similar degree of weight loss but experienced larger reductions in HF-related symptoms and physical limitations with semaglutide than those with lower NT-proBNP.

Indexed as

Glucagon-Like PeptidesHeart FailureNatriuretic Peptide, BrainObesityPeptide FragmentsStroke VolumeAgedDouble-Blind MethodFemaleHumansMaleMiddle AgedSemaglutideTreatment OutcomeGlucagon-Like PeptidesNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)Semaglutideheart failure with preserved ejection fractionN-terminal pro–B-type natriuretic peptideobesitysemaglutide

Identifiers

PMID38819334

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.