New insights from the SELECT trial reveal that semaglutide’s cardiovascular benefits extend beyond weight reduction. Researchers have identified protective effects that suggest potential broader therapeutic applications for this treatment, particularly in patients with obesity and cardiovascular disease.
The SELECT trial, a phase 3, randomized, placebo-controlled study, evaluated semaglutide’s efficacy in reducing major adverse cardiovascular events (MACE) in 17,604 non-diabetic patients with obesity or overweight and cardiovascular disease. Participants aged 45 and older with a body mass index (BMI) of 27 kg/m² or higher were included. They received escalating doses of semaglutide or placebo.
Key findings indicate that higher BMI correlated with increased cardiovascular risks, such as prediabetes and hypertension. Semaglutide significantly reduced MACE incidence, irrespective of baseline body measurements. By week 20, semaglutide recipients showed substantial reductions in body weight and waist circumference compared to the placebo group.
Interestingly, while early weight loss did not correlate linearly with cardiovascular benefits, waist circumference reduction did. The study found a 33% mediation effect of waist circumference on semaglutide’s impact on MACE reduction, highlighting the complex interplay between adiposity and cardiovascular health.
These findings underscore the potential for semaglutide to offer cardioprotective benefits beyond adiposity reduction. However, the results are exploratory and may not be universally applicable due to the demographic limitations of the study population. The trial was funded by Novo Nordisk and is registered under ClinicalTrials.gov Identifier NCT03574597.
