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Background <p>Semaglutide has emerged as an effective medication for treating type 2 diabetes mellitus (DM). However, the cardiovascular effects and safety of this agent in patients with heart failure with preserved ejection fraction (HFpEF) are unclear.</p> Objective <p>This systematic review and meta-analysis aimed to assess the clinical and laboratory effects of semaglutide compared to placebo in patients with HFpEF.</p> Methods <p>We systematically searched EMBASE, PubMed, and Cochrane databases for randomized controlled trials (RCTs) and non-randomized cohorts, from inception to July 2024, comparing semaglutide versus placebo in patients with HFpEF. Statistical analyses were performed using R Studio 4.3.2. Mean difference (MD) and odds ratio (OR) with 95% confidence intervals (CIs) were pooled across trials.</p> Results <p>This meta-analysis included three studies, two RCTs and one non-randomized cohort, reporting data on 1463 patients. The follow-up time of the studies was 52 weeks. Compared to placebo, the use of semaglutide was associated with a significant increase in the 6-min walk distance (MD 16.20; 95% CI 10.19–22.21; <i>p</i> &lt; 0.01; <i>I</i><sup>2</sup> = 0%). Additionally, reductions were observed in systolic blood pressure (MD −2.22; 95% CI −3.60 to −0.83; <i>p</i> &lt; 0.01; <i>I</i><sup>2</sup> = 0%), C-reactive protein level (MD 0.59; 95% CI 0.49–0.70; <i>p</i> &lt; 0.01; <i>I</i><sup>2</sup> = 51%), and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels (MD 0.81; 95% CI 0.74–0.89; <i>p</i> &lt; 0.01; <i>I</i><sup>2</sup> = 0%).</p> Conclusion <p>These findings suggest that the use of semaglutide is associated with clinical and laboratory benefits in patients with HFpEF.</p>

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Cardiovascular Effects of Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-Analysis

  • 期刊论文

  • 发表日期：

    2025年2月5日

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  • Milene Vitória Sampaio Sobral,
  • Livia Kneipp Rodrigues,
  • Abner Mácola Pacheco Barbosa,
  • Naila Camila da Rocha,
  • Isac Ribeiro Moulaz,
  • João Pedro Pereira dos Santos,
  • Bruno Henrique Couto Oliveira,
  • Moreira João Lucas de Magalhães Leal,
  • Francis Lopes Pacagnelli,
  • Camila Mota Guida

摘要

Background

Semaglutide has emerged as an effective medication for treating type 2 diabetes mellitus (DM). However, the cardiovascular effects and safety of this agent in patients with heart failure with preserved ejection fraction (HFpEF) are unclear.

Objective

This systematic review and meta-analysis aimed to assess the clinical and laboratory effects of semaglutide compared to placebo in patients with HFpEF.

Methods

We systematically searched EMBASE, PubMed, and Cochrane databases for randomized controlled trials (RCTs) and non-randomized cohorts, from inception to July 2024, comparing semaglutide versus placebo in patients with HFpEF. Statistical analyses were performed using R Studio 4.3.2. Mean difference (MD) and odds ratio (OR) with 95% confidence intervals (CIs) were pooled across trials.

Results

This meta-analysis included three studies, two RCTs and one non-randomized cohort, reporting data on 1463 patients. The follow-up time of the studies was 52 weeks. Compared to placebo, the use of semaglutide was associated with a significant increase in the 6-min walk distance (MD 16.20; 95% CI 10.19–22.21; p < 0.01; I2 = 0%). Additionally, reductions were observed in systolic blood pressure (MD −2.22; 95% CI −3.60 to −0.83; p < 0.01; I2 = 0%), C-reactive protein level (MD 0.59; 95% CI 0.49–0.70; p < 0.01; I2 = 51%), and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels (MD 0.81; 95% CI 0.74–0.89; p < 0.01; I2 = 0%).

Conclusion

These findings suggest that the use of semaglutide is associated with clinical and laboratory benefits in patients with HFpEF.