Semaglutide and Cardiovascular Outcomes: SELECT Trial
Lincoff AM, Brown-Frandsen K, Colhoun HM, et al.
Summary
In 17,604 patients with obesity and established cardiovascular disease (without diabetes), semaglutide 2.4mg reduced major adverse cardiovascular events by 20% over 3.3 years.
Clinical Significance
First trial to prove a weight-loss medication reduces cardiovascular events, independent of diabetes status.
Study Design
- Patients: 17,604 adults with BMI ≥27 and established CVD
- Intervention: Semaglutide 2.4mg weekly vs placebo
- Duration: 3.3 years median follow-up
- Primary endpoint: 3-point MACE (CV death, nonfatal MI, nonfatal stroke)
Primary Endpoint: Major Adverse Cardiovascular Events
| Component | Semaglutide | Placebo | Hazard Ratio |
|---|---|---|---|
| 3-point MACE | 6.5% | 8.0% | 0.80 (p < 0.001) |
| CV death | — | — | 0.84 |
| Nonfatal MI | — | — | 0.74 |
| Nonfatal stroke | — | — | 0.79 |
Weight Loss
| Group | Weight Change |
|---|---|
| Semaglutide | −9.4% |
| Placebo | −0.8% |
Additional Outcomes
- Reduced heart failure hospitalizations
- Improved HbA1c and lipid profiles
- Blood pressure reduction
- Reduced waist circumference
Clinical Implications
SELECT establishes semaglutide as the first weight-loss medication proven to reduce cardiovascular events. This supports its use for CV risk reduction in patients with obesity, even without diabetes.
Sources
Penelitian Terkait
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