TABLE 1.
Major heart failure with preserved ejection fraction trials with role of obesity in outcomes.
| Major heart failure with preserved ejection fraction trials | |||||
| Name | Study type | N | N (BMI > 30 kg/m2) | Treatment modality | Main outcomes |
| I-PRESERVE (Haass et al., 2011) | RCT | 4,128 | 1,409 (34%) | Irbesartan | • Irbesartan did not improve outcomes • BMI >35 kg/m2 associated with worse CV outcomes (HR 1.27, p 0.011) |
| PARAGON-HF (McMurray et al., 2020) | RCT | 4,796 | 2,357 (49.1%) | Sacubitril-Valsartan | Sacubitril-Valsartan did not improve outcomes • No subgroup analysis in obese population (HR 0.87, P 0.06) |
| RELAX (Reddy et al., 2019) | RCT | 216 | 81 (38%) | Sildenafil | • Sildenafil did not improve quality of life or exercise capacity • BMI >35 kg/m2 associated with greater systemic inflammation, worse exercise capacity and worse quality of life |
| TOPCAT (Huynh et al., 2019) | RCT | 1,751 | 1,135 (64.8%) | Spironolactone | • In patients from the Americas with obesity (BMI >30 kg/m2) spironolactone did improve outcomes (HR 0.62 p 0.001) |
| EMPEROR PRESERVED (Anker et al., 2021) | RCT | 2,997 | 1,343 (45%) | Empagliflozin | • Empagliflozin improved composite of CV death or HF hospitalization (HR 0.73 p < 0.001) • Did not improve all cause death Not as effective in BMI > 30 KG/m2 (HR 0.85 p > 0.05) |
HR, Hazard ratio; RCT, Randomized clinical trial.