Incretin therapies improve outcomes in heart failure with preserved ejection fraction and obesity.
- Current status
- EstablishedEvidence stable · Cardiovascular
- Why
- STEP-HFpEF (symptoms, 6-minute walk, CRP) and SUMMIT (CV death or worsening HF, HR 0.62) in people with BMI >= 30. Not applicable to HFpEF without obesity. In SELECT's prespecified heart failure analysis, the HFpEF subgroup had lower MACE (HR 0.69) but the composite heart failure endpoint was not significantly reduced (HR 0.75, 0.52-1.07).
- What would change it
- A trial in HFpEF with BMI < 30.
- Linked studies
- 3 · 3 supports
- Last updated
- Oct 19, 2026
The status is the collection's own judgment on its assessment scale, not a GRADE certainty rating and not medical advice.
01The evidence
The evidence, sorted by what it shows
Supports (3)
- Tirzepatide for Heart Failure with Preserved Ejection Fraction and ObesityRandomized trial · 2025 · Study tier 2 · Different population · Benefit · Industry funded
SUMMIT: HR 0.62 for CV death or worsening HF; driven by HF events (CV death HR 1.58, few events).
- Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trialRandomized trial · 2024 · Study tier 2 · Different population · Benefit · Industry funded
Prespecified SELECT analysis in adults with cardiovascular disease and BMI 27 or more; in the 2273 with HFpEF semaglutide reduced MACE (HR 0.69, 0.51-0.91) but the composite heart failure endpoint was not significantly reduced (HR 0.75, 0.52-1.07).
- Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and ObesityRandomized, double-blind, placebo-controlled, parallel-group, multicentre, phase 3 trial; 52-week treatment period · 2023 · Study tier 2 · Different population · Benefit
STEP-HFpEF: KCCQ-CSS +7.8 points; weight -13.3%.
02History
How this assessment has changed
- EstablishedOct 19, 2026 · Evidence stable
Owner decision 2026-10-18 on IN-061 (claims audit): recommended options accepted (IN-061.31). Status unchanged; rationale corrected to match the audited links.
- EstablishedSep 13, 2026 · Evidence stable
initial curated status