{"id":"160644bde458","type":"article","url":"https://hartvaat.nl/2024/07/02/semaglutide-en-nt-probnp-bij-hfpef-met-obesitas-step-hfpef-programma/","title":"Semaglutide en NT-proBNP bij HFpEF met obesitas: STEP-HFpEF programma","title_en":"Semaglutide and NT-proBNP in Obesity-Related HFpEF: Insights From the STEP-HFpEF Program.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":["cagrisema","nt-probnp","obesitas","select-trial","step-hfpef","summit-trial"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2024.04.022","source_url":"https://doi.org/10.1016/j.jacc.2024.04.022","authors":["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","Eduardo Perna","Kavita Sharma","Justin A Ezekowitz","Michael Fu","Vojtěch Melenovský","Hiroshi Ito","Małgorzata Lelonek","Mikhail N Kosiborod"],"significance":7,"published":"2024-07-02","source_date":"2024-07-02","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/bnp-en-nt-probnp/","https://hartvaat.nl/kennis/diagnostiek/cardiale-biomarkers-overzicht/"],"congress":"","summary_en":"This STEP-HFpEF analysis showed that semaglutide significantly reduces NT-proBNP in patients with obesity-related HFpEF, providing a biomarker-based confirmation of the drug's cardiac benefit beyond symptoms and weight loss.","created":"2026-07-03T10:31:01Z","updated":"2026-07-03T13:30:03Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Analyse van het STEP-HFpEF programma toonde dat semaglutide het NT-proBNP significant verlaagde bij HFpEF met obesitas. De biomarkerreductie correleerde met de symptoomverbetering, wat het cardiale voordeel van gewichtsverlies onderstreept.","abstract_original":"BACKGROUND: The 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. OBJECTIVES: This 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. METHODS: This 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. RESULTS: In 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). CONCLUSIONS: In 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."}