Late-Breaking Science Abstracts and Featured Science Abstracts From the American Heart Association’s Scientific Sessions 2023 and Late-Breaking Abstracts in Resuscitation Science From the Resuscitation Science Symposium 2023
Authors: Abraham M Lincoff, Kirstine Brown-Frandsen, Helen M Colhoun, John Deanfield, Scott S Emerson, Sille Esbjerg, Søren Hardt-Lindberg, G. Kees Hovingh, Steven E Kahn, Robert F Kushner, Ildiko Lingvay, Tugce Kalayci Oral, Marie M Michelsen, Jorge Plutzky, Christoffer W Tornoee, Donna H Ryan, The SELECT Trial Investigators, Dept of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Business Development, Novo Nordisk A/S, Søborg, Denmark, Institute of Genetics and Cancer, Univ of Edinburgh, Edinburgh, United Kingdom, Dept of Clinical Science, Univ College London, London, United Kingdom, Dept of Biostatistics, Univ of Washington, Seattle, Dept of Biostatistics, Novo Nordisk A/S, Søborg, Denmark, Project Management - 5 CKAD, Novo Nordisk A/S, Søborg, Denmark, Global Medical Affairs, Novo Nordisk A/S, Søborg, Denmark, Dept of Medicine, VA Puget Sound Health Care System and Univ of Washington, Seattle, Dept of Medicine and Medical Education, Northwestern Univ, Chicago, Dept of Internal Medicine/Endocrinology, UT Southwestern Medical Center at Dallas, Dallas, Med & Science, Novo Nordisk A/S, Søborg, Denmark, Cardiovascular Medicine Division, Brigham and Womens Hospital, Harvard Medical School, Boston, Obesity, Liver Diseases and Devices, Novo Nordisk A/S, Søborg, Denmark, Clinical Research, Pennington Biomedical Research Center, Baton Rouge
Journal: Circulation (2023)

Background: Semaglutide, a long-acting agonist of the glucagon-like peptide-1 receptor, is approved for use in people with type 2 diabetes and overweight or obesity.It has been shown to reduce the risk of adverse cardiac events in those with type 2 diabetes.Whether semaglutide can reduce cardiovascular risk associated with overweight and obesity in the absence of diabetes is unknown.Methods: In a multicenter, randomized, double-blind, placebo-controlled eventdriven superiority trial, we enrolled 17,604 patients 45 years of age or older with pre-existing cardiovascular disease and a body mass index of 27 kg/m2 or greater, but who did not have diabetes.Patients were randomly assigned to receive once weekly subcutaneous semaglutide 2.4 mg or placebo.The primary cardiovascular efficacy endpoint was any component of the composite of death from cardiovascular causes, non-fatal myocardial infarction, or non-fatal stroke in a time-to-first-event analysis.Confirmatory secondary endpoints, assessed in a time-to-first-event analyses and tested in hierarchical order, were death from cardiovascular causes, a heart failure composite of death from cardiovascular causes or hospitalization or urgent medical visit for heart failure, and death from any cause.Supportive secondary endpoints, also assessed in a time-to-first-event analyses but without control for multiplicity, included expanded cardiovascular composite endpoints, individual components of cardiovascular composite endpoints, a composite nephropathy endpoint, progression to diabetes, or progression to prediabetes as diagnosed by glycated hemoglobin levels.Changes from randomization to week 104 in body weight, glycated hemoglobin concentrations, and other cardiovascular risk factors were measured.Results: The trial met its primary objective, with a 20% reduction in the primary endpoint by semaglutide compared with placebo.Details of primary and secondary efficacy endpoints and safety findings will be presented.Conclusions: In patients with pre-existing cardiovascular disease and overweight or obesity, but without diabetes, weekly subcutaneous semaglutide 2.4 mg was superior to placebo in reducing the incidence of major adverse cardiovascular events.