SELECT Trial Breakthrough: Semaglutide Cuts Heart Risks by 20% in Overweight, Non-Diabetics!

The landmark SELECT trial reveals semaglutide, a diabetes drug, slashes heart attack and stroke risk in overweight people without diabetes.

DR T S DIDWAL MD

12/18/20235 min read

"Semaglutide Triumph: A Breakthrough in Cardiovascular Health for Overweight Individuals"

The Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity (SELECT) study published in the journal New England Journal of Medicine investigated whether the drug semaglutide, effective in reducing heart risks in diabetes patients, could also benefit people with excess weight and existing cardiovascular disease but no diabetes.

Semaglutide's Cardiovascular Impact: Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has shown significant promise in reducing cardiovascular risks, particularly in individuals with preexisting cardiovascular disease and overweight or obesity but without diabetes.
Groundbreaking Trial Design: The Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity trial employed a meticulous multicenter, double-blind, randomized, and placebo-controlled design. This robust methodology ensured reliable evaluation and comparison.
Superior Outcomes with a 2.4 mg Dose: The study's results indicated that a weekly subcutaneous Semaglutide dose of 2.4 mg was superior in reducing major adverse cardiovascular events (MACE) compared to a placebo. This includes a decreased risk of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke.
Rigorous Safety Assessment: Despite its efficacy, semaglutide did show a higher rate of adverse events leading to the discontinuation of the trial product compared to the placebo. Safety considerations play a crucial role in evaluating the overall impact and feasibility of semaglutide as a cardiovascular intervention.
Trial Demographics: The trial focused on individuals aged 45 and above with preexisting cardiovascular disease and a body-mass index of 27 or greater but without diabetes. This targeted approach helps in understanding the specific demographic benefiting from semaglutide.
Hope for a Healthier Future: Funded by Novo Nordisk, the study's findings present Semaglutide as a beacon of hope for those with preexisting cardiovascular conditions and overweight or obesity but without diabetes. It opens new avenues for cardiovascular
health interventions and emphasizes the importance of ongoing research in this field.

In a world where over 70% of the U.S. adult population battles obesity, the quest for effective interventions is more critical than ever. Recent developments have spotlighted semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, as a potential game-changer in the fight against cardiovascular disease.

The Weighty Issue of Cardiovascular Health

The Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity Trial took a groundbreaking approach, investigating whether semaglutide could transcend its success in diabetes management to reduce cardiovascular risk in individuals without diabetes. The study, encompassing patients with preexisting cardiovascular disease and overweight or obese but without diabetes, explored the impact of weekly subcutaneous Semaglutide at a dose of 2.4 mg on major adverse cardiovascular events (MACE).

Superior Cardiovascular Outcomes

Results unequivocally demonstrated the superiority of semaglutide in reducing cardiovascular outcomes in patients with preexisting cardiovascular disease and overweight or obesity but without diabetes. The 2.4 mg dose emerged as a key player in mitigating the risk of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke.

Rigorous Trial Design

In a meticulously designed multicenter, double-blind, randomized, placebo-controlled trial, patients aged 45 and above with preexisting cardiovascular disease and a body-mass index of 27 or greater but no history of diabetes were enrolled. The 1:1 random assignment to receive semaglutide or placebo laid the foundation for a robust evaluation.

Compelling Results

Out of the 17,604 enrolled patients, those receiving semaglutide at 2.4 mg demonstrated a significant reduction in primary cardiovascular endpoints compared to the placebo group. The hazard ratio of 0.80 (95% confidence interval, 0.72 to 0.90; P<0.001) underscored the efficacy of semaglutide.

Key findings:

In this large study with over 17,000 participants, weekly semaglutide injections reduced the risk of major cardiovascular events like heart attacks and strokes by 20% compared to placebo after an average of 3 years.
This means that for every 100 people treated with semaglutide, 8 fewer experienced a major cardiovascular event compared to those receiving placebo.
While semaglutide was well-tolerated, it caused slightly more side effects, mainly gastrointestinal issues, compared to placebo.

Significance:

This study offers a new tool for preventing cardiovascular disease in a large population at high risk due to both excess weight and existing heart problems.
Semaglutide could significantly improve long-term health outcomes for millions of people

Safety Considerations

While semaglutide showcased remarkable cardiovascular benefits, it's essential to note the comprehensive safety assessment. Adverse events leading to permanent discontinuation of the trial product occurred more frequently in the semaglutide group (16.6%) compared to the placebo group (8.2%).

Key points

1. Breakthrough: Semaglutide, a medication already effective for diabetes, has been shown to prevent major adverse cardiovascular events (MACE) in overweight or obese individuals without diabetes who have existing cardiovascular disease. This is a significant breakthrough in preventing heart attacks, strokes, and other cardiovascular complications in this large population.

2. Study Design: The SELECT trial was a large, rigorous study involving over 17,000 participants with preexisting cardiovascular disease and a BMI of 27 or higher. They were randomly assigned to receive weekly subcutaneous injections of semaglutide (2.4mg) or placebo for an average of 34 months.

3. Positive Results: Compared to placebo, semaglutide significantly reduced the risk of MACE by 20%. This means that for every 100 individuals treated with semaglutide, 8 fewer would experience a major cardiovascular event compared to those receiving placebo.

4. Safety Concerns: Semaglutide was associated with a slightly higher rate of side effects compared to placebo, with more participants experiencing gastrointestinal issues and discontinuing the medication. However, overall, the medication was well-tolerated.

5. Implications: This study shows that semaglutide could be a valuable tool for preventing cardiovascular disease in a large population previously considered at high risk. This could significantly improve long-term health outcomes for millions of people.

6. Future Research: Further research is needed to understand the long-term benefits and risks of semaglutide in this population. Additionally, studies are needed to determine if semaglutide effectively prevents MACE in individuals without existing cardiovascular disease or in those with different BMI ranges.

Conclusion: A Beacon of Hope

In conclusion, semaglutide has emerged as a beacon of hope in the realm of cardiovascular health. The study's findings, funded by Novo Nordisk, open new doors for individuals with preexisting cardiovascular disease and overweight or obesity but without diabetes.

Reference Article

Marso, S. P., Bain, S. C., Consoli, A., Eliaschewitz, F. G., Jódar, E., Leiter, L. A., Lingvay, I., Rosenstock, J., Seufert, J., Warren, M. L., Woo, V., Hansen, O., Holst, A. G., Pettersson, J., Vilsbøll, T., & the SUSTAIN-6 Investigators. (2016). Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. The New England Journal of Medicine, 375, 1834-1844. DOI: 10.1056/NEJMoa1607141 1.

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