Patient-reported outcome assessment in heart failure with preserved ejection fraction: A systematic review of semaglutide trials using the Kansas City Cardiomyopathy Questionnaire

Figure 1 PRISMA 2020 flow diagram for study selection. Flow of records through the systematic review. After duplicate removal and sequential screening of titles/abstracts and full texts, 3 unique studies (2 randomised controlled trials and 1 prospective cohort study) comprising 7 primary and companion reports were included in the qualitative synthesis and meta-analysis.

Figure 2 Forest plot of fixed-effects meta-analysis: Pooled placebo-corrected Kansas City Cardiomyopathy Questionnaire Clinical Summary Score treatment effect of semaglutide in obesity-related heart failure with preserved ejection fraction. Individual trial estimates: Semaglutide treatment effect in people with obesity and heart failure with preserved ejection fraction (STEP-HFpEF), +7.8 points (95%CI: 4.8-10.9; weight 44.8%); STEP-HFpEF and diabetes mellitus, +7.0 points (95%CI: 4.3-9.8; weight 55.2%). Pooled fixed-effects estimate: 7.36 points (95%CI: 5.32-9.40; P < 0.001; I² = 0%). The vertical dashed line represents the minimal clinically important difference (5 points). KCCQ-CSS: Kansas City Cardiomyopathy Questionnaire Clinical Summary Score; STEP-HFpEF: Semaglutide treatment effect in people with obesity and heart failure with preserved ejection fraction; STEP-HFpEF DM: Semaglutide treatment effect in people with obesity and heart failure with preserved ejection fraction and diabetes mellitus; HFpEF: Heart failure with preserved ejection fraction; MD: Mean difference; CI: Confidence interval; MCID: Minimal clinically important difference; RoB 2: Cochrane Risk of Bias 2 tool.