Semaglutide and Hospitalizations in Patients With Obesity and Established Cardiovascular Disease

Nicholls, S.J.; Ryan, D.H.; Deanfield, J.; Ferreira, D.; Lang, C.C.; Michael Lincoff, A.; Lingvay, I.; Lübker, C.; Paula Pérez Terns,; Rasmussen, S.; Stensen, S.; Weeke, P.E.; Kahn, S.E.; Nibouche, D.E.; Chettibi, M.; Hammoudi, N.; Porto, A.; Oviedo, A.; Sanabria, H.D.; Casas, M.; Farias, E.; Duronto, E.; Chacon, C.; Villarino, A.; Farias, J.M.; Zaidman, C.J.; Morbey, C.; Colquhoun, D.M.; Ekinci, E.I.; Leung, M.; William, M.; Kostner, K.; Shirazi, M.; Cross, D.; Amerena, J.; Purnell, P.; Arstall, M.; Abhayaratna, W.P.; Toplak, H.; Prager, R.; Ludvik, B.; Kautzky-Willer, A.; Hanusch, U.; Aigner, E.; Kaser, S.; Michel De Pauw,; Vanduynhoven, P.; Philippe Van De Borne,; Vercammen, C.; Verwerft, J.; Vrolix, M.; Turatti, L.A.; Saraiva, J.F.; Cercato, C.; Kormann, A.P.; Leite, S.O.; Rossi, P.; Arantes, F.B.; Maia, L.N.; Kaiser, S.E.; Fonseca, A.G.; Kurtz Lisboa, H.R.; Franco, D.R.; Nicolau, J.C.; Farsky, P.S.; Ritt, L.E.; Goudev, A.; Vassilev, D.; Runev, N.; Georgiev, B.; Katova, T.; Petrov, I.; Gelev, V.; Milanova, M.; Postadzhiyan, A.; Tokmakova, M.; Yotov, Y.; Snezhanka Tisheva Gospodinova,; Minkova, D.A.; Prakova-Teneva, Z.R.; Vasileva, S.P.; Egan, A.; Tsoukas, G.M.; Verma, S.; Bourgeois, R.; Filteau, P.; Vijayaraghavan, R.; Hartleib, M.; Spaic, T.; Stewart, J.; Pandey, A.S.; Rabasa-Lhoret, R.; St-Maurice, F.; Cha, J.Y.; Pedersen, S.; Allison, R.; Poirier, P.; Langlois, M.; Lau, D.; Robitaille, Y.; Weisnagel, J.; Constance, C.; Datta, S.; Garg, N.; Salter, T.; Vale, N.; Vallieres, G.; Peters, K.; Tellier, G.; Rodrigo Botero Lopez,; Urina Triana, M.A.; Cadena Bonfanti, A.J.; Accini Mendoza, J.L.; Rodriguez Plazas, J.A.; Martinez Cano, C.A.; Milicic, D.; Silvija Canecki Varzic,; Budincevic, H.; Delic-Brkljacic, D.; Ruzic, A.; Kruljac, I.; Fuckar, K.; Linhart, A.; Malecha, J.; Cermak, O.; Koleckar, P.; Klimsa, Z.; Kuchar, L.; Malicherova, E.; Stasek, J.; Haluzik, M.; Vesela, A.; Mæng, M.; Hove, J.D.; Egstrup, K.; Jensen, S.E.; Gislason, G.; Bøttcher, M.; Pietilä, M.; Ilveskoski, E.; Lakka, T.; Ahtiainen, P.; Ukkola, O.; Niskanen, L.; Keski-Opas, T.; Schiele, F.; Stephan, D.; Petit, C.; Kerneis, M.; Cariou, B.; Steg, G.; Verges, B.; Hulot, J.; Demicheli, T.; Thuan, J.; Gilles Barone Rochette,; Gatta-Cherifi, B.; Serusclat, P.; Al-Zoebi, A.; Appel, K.; Kreutzmann, K.; Chevts, J.; Denger, R.J.; Eggebrecht, H.; Charlotte Von Engelhardt,; Hagenow, A.; Heymer, P.; Jacob, S.; Jungmair, W.; Kahrmann, G.; Kempe, H.; Candy Von Münchhausen,; Lehrke, M.; Wagner, J.; Froer, M.; Sauter, J.; Meyhöfer, S.; Zeller, H.; Segner, A.; Stahl, H.; Steindorf, J.; Sturm, K.; Schaum, T.; Wendisch, U.; Liberopoulos, E.; Bargiota, A.; Tziomalos, K.; Lambadiari, V.; Pagkalos, E.; Kokkinos, A.; Argyrakopoulou, G.; Siasos, G.; Patsilinakos, S.; Lanaras, L.; Kartalis, A.; Ntaios, G.; Stamatelopoulos, K.; Tsougos, E.; Páll, D.; Kocsis, G.; Takács, R.; Baranyai, M.; Lupkovics, G.; Piros, A.; Könyves, L.; Kaul, U.; Mittal, S.; Jitendra Pal Singh Sawhney,; Garg, S.; Roy, A.; Gandotra, D.; Thomas, N.; Kahali, D.; Abhaichand, R.K.; Christopher, J.; Hiremath, S.; Kannan, J.; Sethi, R.; Shah, M.K.; Naik, A.; Prafulla Kerkar, G.; Varghese, K.; Abhyankar, A.; Bhagwat, A.; Wander, G.S.; Chopra, A.K.; Parvathareddy, K.M.; Bansal, S.; Mahajan, A.U.; Pothineni, R.B.; Desai, D.; Vijan, V.; Agarwal, D.K.; Fulwani, M.; Arneja, J.; Desai, P.; Maher, V.; Molony, D.; Mcdonald, K.; Byrne, M.; O'Shea, D.; Sreenan, S.; Carel Le Roux,; Mosenzon, O.; Durst, R.; Bashkin, A.; Sofer, Y.; Vishlitzky, V.; Gabriella Segal Lieberman,; Shechter, M.; Dicker, D.; Zornitzki, T.; Liberty, I.; Shehadeh, N.; Arbel, Y.; Buscemi, S.; Pagotto, U.; Vettor, R.; Santini, F.; Mingrone, G.; Dotta, F.; Cortinovis, F.; Cogni, G.; Simona, B.; Frittitta, L.; Malavazos, A.; Bucci, M.; Mannucci, E.; Sbraccia, P.; Colao, A.M.; Zatelli, M.C.; Muratori, F.; Leonetti, F.; Tuccinardi, D.; Mirani, M.; Berra, C.; Ohsugi, M.; Tanaka, H.; Onaka, H.; Watanabe, A.; Sugiura, T.; Morisaki, K.; Nagano, T.; Doi, M.; Natsuaki, M.; Miyamoto, N.; Fujii, K.; Fumiki, O.; Mitomo, S.; Kawanishi, M.; Kitamura, R.; Maeda, H.; Miyake, T.; Kinoshita, N.; Sato, A.; Takeuchi, Y.; Ueda, O.; Kiyosue, A.; Kodera, S.; Manita, M.; Fukushima, Y.; Kinoshita, M.; Yamasaki, M.; Sueyoshi, A.; Ando, T.; Hanaoka, K.; Isawa, T.; Hata, Y.; Kunishige, H.; Oguri, M.; Abe, M.; Matsumoto, T.; Ono, Y.; Okada, Y.; Kato, T.; Koga, T.; Fujita, R.; Sakamoto, T.; Okayama, H.; Kadokami, T.; Yamaguchi, H.; Iwasawa, T.; Maeda, I.; Teragawa, H.; Ezaki, H.; Lace, A.; Veze, I.; Rezgale, I.; Latkovskis, G.; Sime, I.; Teterovska, D.; Rancane, G.; Klavina, I.; Bang, L.H.; Ong, T.K.; Krishinan, S.; Lee, L.Y.; Ali, N.; Ruhani, A.I.; Hussein, Z.; Rosman, A.; Abidin, I.B.; Wan Mohamed, W.M.; Kasim, S.S.; Morales Villegas, E.C.; Raymundo García Reza,; Arenas León, J.L.; Lazcano Soto, J.R.; Bazzoni Ruiz, A.E.; Garcia Hernandez, P.A.; Jimenez-Ramos, S.A.; Arias Mendoza, M.A.; De Los Rios Ibarra, M.O.; Van Beek, A.P.; Schaap, J.; Swart, H.; Martens, F.M.A.C.; Nierop, P.; Vossenberg, T.; Van Der Zwaan, C.; Dorman, R.; Groenemeijer, B.; Römer, T.J.; Hjelmesaeth, J.; Tonstad, S.; Halvorsen, S.; Gullestad, L.; Tone Gretland Valderhaug,; Høivik, H.O.; Høgalmen, R.G.; Nygård, O.K.; Rice, E.; Bogdanski, P.; Franek, E.; Gajos, G.; Ostrowska, L.; Szyprowska, E.; Lukaszewicz, M.; Kania, G.; Skoczylas, G.; Kujawiak, M.; Wozniak, I.; Chrustowski, W.; Jozefowska, M.; Leksycka, A.; Jurowiecki, J.; Czochra, W.; Pulka, G.; Karczmarczyk, A.; Stogowska-Nikiciuk, B.; Kalmucki, P.; Beckowski, M.; França, S.; Fonseca, L.; Martins, C.; Monteiro, P.; Pinto, F.; Hancu, N.; Vlad, A.; Pop, L.; Onaca, A.; Cif, A.; Kurtinecz, M.; Vladu, I.M.; Constantin, C.; Nafornita, V.; Toarba, C.; Constantinescu, S.; Avram, R.; Nicolescu, G.; Popa, B.; Cosma, D.; Marin, L.; Reurean Pintilei, D.V.; Morosanu, M.; Mîndrescu, N.M.; Mistodie, C.V.; Badiu, C.V.; Lupu, S.; Enculescu, D.; Caceaune, E.; Enache, G.; Gordeev, I.G.; Shaydyuk, O.; Kobalava, Z.; Khlevchuk, T.; Ezhov, M.; Mareev, V.; Vorobyeva, O.; Markova, T.; Ermakova, P.; Bolshakova, O.O.; Alpenidze, D.; Zrazhevskiy, K.; Sardinov, R.; Obrezan, A.; Zalevskaya, A.; Zagrebelnaya, O.; Dvoryashina, I.V.; Platonov, D.; Khaisheva, L.; Shutemova, E.; Sergeeva Kondrachenko, M.Y.; Smolenskaya, O.; Suplotova, L.A.; Shalaev, S.; Gilinskaya, O.; Barbarash, O.; Ryabov, V.V.; Boshchenko, A.A.; Samoilova, Y.; Veselovskaya, N.G.; Lysenko, T.A.; Zhdanova, E.A.; Zykov, M.; Belousova, L.; Peskov, A.B.; Ipatko, I.; Gurieva, I.; Ruyatkin, D.; Antonova, E.; Kazakova, E.E.; Ershova, O.; Vinogradova, O.; Guseva, G.N.; Pergaeva, Y.; Kharakhulakh, M.; Sorokin, M.; Krivosheeva, I.; Galyavich, A.; Sveklina, T.; Lalic, N.; Lalic, K.; Djenic, N.; Vukicevic, M.; Stokic, E.; Asanin, M.; Stankovic, G.; Ristic, A.; Ebrahim, I.O.; Urbach, D.; Corbett, C.; Lombard, L.; Badat, A.; Fulat, M.; Kapp, C.; Bandezi, V.N.; Moosa, N.; De Jong, D.M.; Tsabedze, N.; Eugene Van Der Walt,; Elane Van Nieuwenhuizen,; Wadvalla, S.; Burgess, L.; Coetzee, K.; Dawood, S.Y.; Peter, J.; Louis Van Zyl,; Fourie, N.; Lombaard, J.J.; Makotoko, E.M.; Jugnundan, P.; Punt, Z.E.; Klug, E.; Tinahones, F.; Carmen De Pablo,; Carmen De La Cuesta,; Alfonso Soto González,; Merino Torres, J.F.; Luis Masmiquel Comas,; Margarita Rivas Fernández,; Castro, A.; Cristobal Morales Portillo,; Pedro Mezquita Raya,; Olga González Albarrán,; Rydén, L.; Eliasson, B.; Holmer, H.; Mooe, T.; Eliasson, K.; Lindholm, C.; Chau-Chung, W.; Hsieh, I.; Yeh, H.; Liu, M.; Lee, T.; Suwanwalaikorn, S.; Suwanagool, A.; Piyayotai, D.; Buranapin, S.; Vathesatogkit, P.; Udommongkol, C.; Sansanayudh, N.; Kiatchoosakun, S.; Wongcharoen, W.; Dagdelen, S.; Sonmez, Y.A.; Sancak, S.; Kayikcioglu, M.; Unubol, M.; Sari, R.; Bakiner, O.S.; Celik, A.; Altuntas, Y.; Dilek Gogas Yavuz,; Ozpelit, E.; Gul, I.; Ozdogan, O.; Yazici, D.; Araz, M.; Adas, M.; Tuna, M.M.; Ozlem Soyluk Selcukbiricik,; Kanadasi, M.; Oguzhan, A.; Parkhomenko, O.; Lysak, Z.; Rudenko, L.; Velychko, V.; Levchenko, O.; Mostovoy, Y.; Stanislavchuk, M.; Kushnir, M.; Vyshnyvetskyy, I.; Ilashchuk, T.; Buriakovska, O.; Leonidova, V.; Kyyak, Y.; Horoshko, O.; Todoriuk, L.; Myshanych, G.; Wilding, J.; Andrews, R.; Asamoah, N.; Barber, M.; Bellary, S.; Broadley, A.; Capehorn, M.; Clark, R.; Clifford, P.; Stoker, J.; Creely, S.; Dang, C.; Dobson, S.; English, P.; Jackson-Voyzey, E.; Tatovic, D.; Keeling, P.; Khoo, J.; Lynch, M.; Lee, K.; Mcgowan, B.; Beerachee, Y.; Miras, A.; Myint, M.; Nair, S.; Paul, N.; Price, H.; Randeva, H.; Sathyapalan, T.; Senior, R.; Sharma, R.; Sharma, S.; Strzelecka, A.; Swanson, N.; Tait, G.; Vaidya, B.; Vincent, R.; Wakeling, J.; Wilson, P.; Wong, Y.; Wyatt, N.; Agaiby, J.M.; Al-Karadsheh, A.; Apovian, C.; Arif, A.A.; Aroda, V.R.; Shea, H.C.; Barnum, O.; Berk, M.; Pereira, I.; Biggs, W.C.; Billings, L.; Brautigam, D.; Brockmyre, A.P.; Budoff, M.J.

doi:10.1001/jamacardio.2025.4824

Importance The primary analysis of the SELECT randomized clinical trial suggests that semaglutide reduced the rates of cardiovascular (CV) death, myocardial infarction, and stroke in patients with established CV disease (CVD) and overweight or obesity without diabetes. However, the effect of semaglutide on hospitalizations in this population remains unknown. Objective To determine the impact of semaglutide on total hospital admissions and duration of hospital stay. Design, Setting, and Participants The SELECT trial included patients aged 45 years or older with established CVD and a body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) of 27 or higher without diabetes at 804 clinical settings across North America, South America, Europe, Asia, Africa, and Australia. Patients were randomized from October 2018 to March 2021. This prespecified exploratory analysis was conducted from February 2024 to September 2025. Interventions Once-weekly subcutaneous semaglutide, 2.4 mg, or placebo. Main Outcomes and Measures The total number of hospital admissions and days in hospital between the semaglutide and placebo groups. Results A total of 17 604 patients (median [IQR] age, 61.0 [55.0-68.0] years; 4872 female patients [27.7%]; median [IQR] BMI, 32.1 [29.7-35.7]) were followed up for a median (IQR) period of 41.8 (33.0-47.0) months. There were 11 287 hospital admissions. The number of total hospitalizations was lower in the semaglutide group vs placebo for any indication (18.3 vs 20.4 admissions per 100 patient-years; mean ratio [MR], 0.90; 95% CI, 0.85-0.95; P < .001) and for serious adverse events (15.2 vs 17.1 admissions per 100 patient-years; MR, 0.89; 95% CI, 0.84-0.94; P < .001). The number of days hospitalized for any indication per 100 patient-years was lower in the semaglutide group vs placebo (157.2 vs 176.2 days; rate ratio [RR], 0.89; 95% CI, 0.82-0.98; P = .01), as well as hospitalizations for serious adverse events (137.6 vs 153.9 days; RR, 0.89; 95% CI, 0.81-0.98; P = .02). No heterogeneity was observed for the reduction of hospital admissions with semaglutide in selected subgroups, including BMI, age, and sex. Conclusions and Relevance In this prespecified exploratory analysis of the SELECT randomized clinical trial, the trial cohort had a high rate of hospital admissions. Treatment with once-weekly semaglutide was associated with significant reductions in hospital admissions and overall time spent in hospital, extending its benefits beyond CV risk reduction.

Semaglutide and Hospitalizations in Patients With Obesity and Established Cardiovascular Disease / S.J. Nicholls, D.H. Ryan, J. Deanfield, D. Ferreira, C.C. Lang, A. Michael Lincoff, I. Lingvay, C. Lübker, P. Pérez Terns, S. Rasmussen, S. Stensen, P.E. Weeke, S.E. Kahn, D.E. Nibouche, M. Chettibi, N. Hammoudi, A. Porto, A. Oviedo, H.D. Sanabria, M. Casas, E. Farias, E. Duronto, C. Chacon, A. Villarino, J.M. Farias, C.J. Zaidman, C. Morbey, D.M. Colquhoun, E.I. Ekinci, M. Leung, M. William, K. Kostner, M. Shirazi, D. Cross, J. Amerena, P. Purnell, M. Arstall, W.P. Abhayaratna, H. Toplak, R. Prager, B. Ludvik, A. Kautzky-Willer, U. Hanusch, E. Aigner, S. Kaser, M. De Pauw, P. Vanduynhoven, P. Van De Borne, C. Vercammen, J. Verwerft, M. Vrolix, L.A. Turatti, J.F. Saraiva, C. Cercato, A.P. Kormann, S.O. Leite, P. Rossi, F.B. Arantes, L.N. Maia, S.E. Kaiser, A.G. Fonseca, H.R. Kurtz Lisboa, D.R. Franco, J.C. Nicolau, P.S. Farsky, L.E. Ritt, A. Goudev, D. Vassilev, N. Runev, B. Georgiev, T. Katova, I. Petrov, V. Gelev, M. Milanova, A. Postadzhiyan, M. Tokmakova, Y. Yotov, S. Tisheva Gospodinova, D.A. Minkova, Z.R. Prakova-Teneva, S.P. Vasileva, A. Egan, G.M. Tsoukas, S. Verma, R. Bourgeois, P. Filteau, R. Vijayaraghavan, M. Hartleib, T. Spaic, J. Stewart, A.S. Pandey, R. Rabasa-Lhoret, F. St-Maurice, J.Y. Cha, S. Pedersen, R. Allison, P. Poirier, M. Langlois, D. Lau, Y. Robitaille, J. Weisnagel, C. Constance, S. Datta, N. Garg, T. Salter, N. Vale, G. Vallieres, K. Peters, G. Tellier, R. Botero Lopez, M.A. Urina Triana, A.J. Cadena Bonfanti, J.L. Accini Mendoza, J.A. Rodriguez Plazas, C.A. Martinez Cano, D. Milicic, S. Canecki Varzic, H. Budincevic, D. Delic-Brkljacic, A. Ruzic, I. Kruljac, K. Fuckar, A. Linhart, J. Malecha, O. Cermak, P. Koleckar, Z. Klimsa, L. Kuchar, E. Malicherova, J. Stasek, M. Haluzik, A. Vesela, M. Mæng, J.D. Hove, K. Egstrup, S.E. Jensen, G. Gislason, M. Bøttcher, M. Pietilä, E. Ilveskoski, T. Lakka, P. Ahtiainen, O. Ukkola, L. Niskanen, T. Keski-Opas, F. Schiele, D. Stephan, C. Petit, M. Kerneis, B. Cariou, G. Steg, B. Verges, J. Hulot, T. Demicheli, J. Thuan, G. Barone Rochette, B. Gatta-Cherifi, P. Serusclat, A. Al-Zoebi, K. Appel, K. Kreutzmann, J. Chevts, R.J. Denger, H. Eggebrecht, C. Von Engelhardt, A. Hagenow, P. Heymer, S. Jacob, W. Jungmair, G. Kahrmann, H. Kempe, C. Von Münchhausen, M. Lehrke, J. Wagner, M. Froer, J. Sauter, S. Meyhöfer, H. Zeller, A. Segner, H. Stahl, J. Steindorf, K. Sturm, T. Schaum, U. Wendisch, E. Liberopoulos, A. Bargiota, K. Tziomalos, V. Lambadiari, E. Pagkalos, A. Kokkinos, G. Argyrakopoulou, G. Siasos, S. Patsilinakos, L. Lanaras, A. Kartalis, G. Ntaios, K. Stamatelopoulos, E. Tsougos, D. Páll, G. Kocsis, R. Takács, M. Baranyai, G. Lupkovics, A. Piros, L. Könyves, U. Kaul, S. Mittal, J. Pal Singh Sawhney, S. Garg, A. Roy, D. Gandotra, N. Thomas, D. Kahali, R.K. Abhaichand, J. Christopher, S. Hiremath, J. Kannan, R. Sethi, M.K. Shah, A. Naik, G. Prafulla Kerkar, K. Varghese, A. Abhyankar, A. Bhagwat, G.S. Wander, A.K. Chopra, K.M. Parvathareddy, S. Bansal, A.U. Mahajan, R.B. Pothineni, D. Desai, V. Vijan, D.K. Agarwal, M. Fulwani, J. Arneja, P. Desai, V. Maher, D. Molony, K. Mcdonald, M. Byrne, D. O'Shea, S. Sreenan, C. Le Roux, O. Mosenzon, R. Durst, A. Bashkin, Y. Sofer, V. Vishlitzky, G. Segal Lieberman, M. Shechter, D. Dicker, T. Zornitzki, I. Liberty, N. Shehadeh, Y. Arbel, S. Buscemi, U. Pagotto, R. Vettor, F. Santini, G. Mingrone, F. Dotta, F. Cortinovis, G. Cogni, S. Bo, L. Frittitta, A. Malavazos, M. Bucci, E. Mannucci, P. Sbraccia, A.M. Colao, M.C. Zatelli, F. Muratori, F. Leonetti, D. Tuccinardi, M. Mirani, C. Berra, M. Ohsugi, H. Tanaka, H. Onaka, A. Watanabe, T. Sugiura, K. Morisaki, T. Nagano, M. Doi, M. Natsuaki, N. Miyamoto, K. Fujii, F. Oh, S. Mitomo, M. Kawanishi, R. Kitamura, H. Maeda, T. Miyake, N. Kinoshita, A. Sato, Y. Takeuchi, O. Ueda, A. Kiyosue, S. Kodera, M. Manita, Y. Fukushima, M. Kinoshita, M. Yamasaki, A. Sueyoshi, T. Ando, K. Hanaoka, T. Isawa, Y. Hata, H. Kunishige, M. Oguri, M. Abe, T. Matsumoto, Y. Ono, Y. Okada, T. Kato, T. Koga, R. Fujita, T. Sakamoto, H. Okayama, T. Kadokami, H. Yamaguchi, T. Iwasawa, I. Maeda, H. Teragawa, H. Ezaki, A. Lace, I. Veze, I. Rezgale, G. Latkovskis, I. Sime, D. Teterovska, G. Rancane, I. Klavina, L.H. Bang, T.K. Ong, S. Krishinan, L.Y. Lee, N. Ali, A.I. Ruhani, Z. Hussein, A. Rosman, I.B. Abidin, W.M. Wan Mohamed, S.S. Kasim, E.C. Morales Villegas, R. García Reza, J.L. Arenas León, J.R. Lazcano Soto, A.E. Bazzoni Ruiz, P.A. Garcia Hernandez, S.A. Jimenez-Ramos, M.A. Arias Mendoza, M.O. De Los Rios Ibarra, A.P. Van Beek, J. Schaap, H. Swart, F.M.A.C. Martens, P. Nierop, T. Vossenberg, C. Van Der Zwaan, R. Dorman, B. Groenemeijer, T.J. Römer, J. Hjelmesaeth, S. Tonstad, S. Halvorsen, L. Gullestad, T. Gretland Valderhaug, H.O. Høivik, R.G. Høgalmen, O.K. Nygård, E. Rice, P. Bogdanski, E. Franek, G. Gajos, L. Ostrowska, E. Szyprowska, M. Lukaszewicz, G. Kania, G. Skoczylas, M. Kujawiak, I. Wozniak, W. Chrustowski, M. Jozefowska, A. Leksycka, J. Jurowiecki, W. Czochra, G. Pulka, A. Karczmarczyk, B. Stogowska-Nikiciuk, P. Kalmucki, M. Beckowski, S. França, L. Fonseca, C. Martins, P. Monteiro, F. Pinto, N. Hancu, A. Vlad, L. Pop, A. Onaca, A. Cif, M. Kurtinecz, I.M. Vladu, C. Constantin, V. Nafornita, C. Toarba, S. Constantinescu, R. Avram, G. Nicolescu, B. Popa, D. Cosma, L. Marin, D.V. Reurean Pintilei, M. Morosanu, N.M. Mîndrescu, C.V. Mistodie, C.V. Badiu, S. Lupu, D. Enculescu, E. Caceaune, G. Enache, I.G. Gordeev, O. Shaydyuk, Z. Kobalava, T. Khlevchuk, M. Ezhov, V. Mareev, O. Vorobyeva, T. Markova, P. Ermakova, O.O. Bolshakova, D. Alpenidze, K. Zrazhevskiy, R. Sardinov, A. Obrezan, A. Zalevskaya, O. Zagrebelnaya, I.V. Dvoryashina, D. Platonov, L. Khaisheva, E. Shutemova, M.Y. Sergeeva Kondrachenko, O. Smolenskaya, L.A. Suplotova, S. Shalaev, O. Gilinskaya, O. Barbarash, V.V. Ryabov, A.A. Boshchenko, Y. Samoilova, N.G. Veselovskaya, T.A. Lysenko, E.A. Zhdanova, M. Zykov, L. Belousova, A.B. Peskov, I. Ipatko, I. Gurieva, D. Ruyatkin, E. Antonova, E.E. Kazakova, O. Ershova, O. Vinogradova, G.N. Guseva, Y. Pergaeva, M. Kharakhulakh, M. Sorokin, I. Krivosheeva, A. Galyavich, T. Sveklina, N. Lalic, K. Lalic, N. Djenic, M. Vukicevic, E. Stokic, M. Asanin, G. Stankovic, A. Ristic, I.O. Ebrahim, D. Urbach, C. Corbett, L. Lombard, A. Badat, M. Fulat, C. Kapp, V.N. Bandezi, N. Moosa, D.M. De Jong, N. Tsabedze, E. Van Der Walt, E. Van Nieuwenhuizen, S. Wadvalla, L. Burgess, K. Coetzee, S.Y. Dawood, J. Peter, L. Van Zyl, N. Fourie, J.J. Lombaard, E.M. Makotoko, P. Jugnundan, Z.E. Punt, E. Klug, F. Tinahones, C. De Pablo, C. De La Cuesta, A. Soto González, J.F. Merino Torres, L. Masmiquel Comas, M. Rivas Fernández, A. Castro, C. Morales Portillo, P. Mezquita Raya, O. González Albarrán, L. Rydén, B. Eliasson, H. Holmer, T. Mooe, K. Eliasson, C. Lindholm, C. Wu, I. Hsieh, H. Yeh, M. Liu, T. Lee, S. Suwanwalaikorn, A. Suwanagool, D. Piyayotai, S. Buranapin, P. Vathesatogkit, C. Udommongkol, N. Sansanayudh, S. Kiatchoosakun, W. Wongcharoen, S. Dagdelen, Y.A. Sonmez, S. Sancak, M. Kayikcioglu, M. Unubol, R. Sari, O.S. Bakiner, A. Celik, Y. Altuntas, D. Gogas Yavuz, E. Ozpelit, I. Gul, O. Ozdogan, D. Yazici, M. Araz, M. Adas, M.M. Tuna, O. Soyluk Selcukbiricik, M. Kanadasi, A. Oguzhan, O. Parkhomenko, Z. Lysak, L. Rudenko, V. Velychko, O. Levchenko, Y. Mostovoy, M. Stanislavchuk, M. Kushnir, I. Vyshnyvetskyy, T. Ilashchuk, O. Buriakovska, V. Leonidova, Y. Kyyak, O. Horoshko, L. Todoriuk, G. Myshanych, J. Wilding, R. Andrews, N. Asamoah, M. Barber, S. Bellary, A. Broadley, M. Capehorn, R. Clark, P. Clifford, J. Stoker, S. Creely, C. Dang, S. Dobson, P. English, E. Jackson-Voyzey, D. Tatovic, P. Keeling, J. Khoo, M. Lynch, K. Lee, B. Mcgowan, Y. Beerachee, A. Miras, M. Myint, S. Nair, N. Paul, H. Price, H. Randeva, T. Sathyapalan, R. Senior, R. Sharma, S. Sharma, A. Strzelecka, N. Swanson, G. Tait, B. Vaidya, R. Vincent, J. Wakeling, P. Wilson, Y. Wong, N. Wyatt, J.M. Agaiby, A. Al-Karadsheh, C. Apovian, A.A. Arif, V.R. Aroda, H.C. Shea, O. Barnum, M. Berk, I. Pereira, W.C. Biggs, L. Billings, D. Brautigam, A.P. Brockmyre, M.J. Budoff. - In: JAMA CARDIOLOGY. - ISSN 2380-6583. - (2025). [Epub ahead of print] [10.1001/jamacardio.2025.4824]

Semaglutide and Hospitalizations in Patients With Obesity and Established Cardiovascular Disease

Stephen J. Nicholls;Donna H. Ryan;John Deanfield;Daniel Ferreira;Chim C. Lang;A. Michael Lincoff;Ildiko Lingvay;Christopher Lübker;Paula Pérez Terns;Søren Rasmussen;Signe Stensen;Peter E. Weeke;Steven E. Kahn;Djamel E. Nibouche;Mohamed Chettibi;Naima Hammoudi;Alejandro Porto;Alejandra Oviedo;Hugo D. Sanabria;Marcelo Casas;Eduardo Farias;Ernesto Duronto;Carolina Chacon;Adriana Villarino;Javier M. Farias;Cesar J. Zaidman;Claire Morbey;David M. Colquhoun;Elif I. Ekinci;Melissa Leung;Maged William;Karam Kostner;Mitra Shirazi;David Cross;John Amerena;Peter Purnell;Margaret Arstall;Walter P. Abhayaratna;Hermann Toplak;Rudolf Prager;Bernhard Ludvik;Alexandra Kautzky-Willer;Ursula Hanusch;Elmar Aigner;Susanne Kaser;Michel De Pauw;Philippe Vanduynhoven;Philippe Van De Borne;Chris Vercammen;Jan Verwerft;Mathias Vrolix;Luiz A. Turatti;José F. Saraiva;Cintia Cercato;Adrian P. Kormann;Silmara O. Leite;Paulo Rossi;Flávia B. Arantes;Lilia N. Maia;Sergio E. Kaiser;Alberto G. Fonseca;Hugo R. Kurtz Lisboa;Denise R. Franco;José C. Nicolau;Pedro S. Farsky;Luiz E. Ritt;Assen Goudev;Dobrin Vassilev;Nikolay Runev;Borislav Georgiev;Tzvetana Katova;Ivo Petrov;Valeri Gelev;Maria Milanova;Arman Postadzhiyan;Mariya Tokmakova;Yoto Yotov;Snezhanka Tisheva Gospodinova;Dotska A. Minkova;Zhulieta R. Prakova-Teneva;Svetla P. Vasileva;Alan Egan;George M. Tsoukas;Subodh Verma;Ronald Bourgeois;Pierre Filteau;Ram Vijayaraghavan;Michael Hartleib;Tamara Spaic;John Stewart;Amritanshu S. Pandey;Remi Rabasa-Lhoret;Francois St-Maurice;James Y. Cha;Sue Pedersen;Roy Allison;Paul Poirier;Marie-France Langlois;David Lau;Yves Robitaille;John Weisnagel;Christian Constance;Sudip Datta;Naveen Garg;Tim Salter;Noah Vale;Gerald Vallieres;Karina Peters;Guy Tellier;Rodrigo Botero Lopez;Miguel A. Urina Triana;Alberto J. Cadena Bonfanti;Jose L. Accini Mendoza;Jaime A. Rodriguez Plazas;Carlos A. Martinez Cano;Davor Milicic;Silvija Canecki Varzic;Hrvoje Budincevic;Diana Delic-Brkljacic;Alen Ruzic;Ivan Kruljac;Krunoslav Fuckar;Ales Linhart;Jan Malecha;Ondrej Cermak;Pavel Koleckar;Zdenek Klimsa;Ladislav Kuchar;Emilia Malicherova;Josef Stasek;Martin Haluzik;Alica Vesela;Michael Mæng;Jens D. Hove;Kenneth Egstrup;Svend E. Jensen;Gunnar Gislason;Morten Bøttcher;Mikko Pietilä;Erkki Ilveskoski;Timo Lakka;Petteri Ahtiainen;Olavi Ukkola;Leo Niskanen;Tiina Keski-Opas;François Schiele;Dominique Stephan;Catherine Petit;Mathieu Kerneis;Bertrand Cariou;Gabriel Steg;Bruno Verges;Jean-Sébastien Hulot;Thibaud Demicheli;Jean-Francois Thuan;Gilles Barone Rochette;Blandine Gatta-Cherifi;Pierre Serusclat;Ayham Al-Zoebi;Karl-Friedrich Appel;Kristin Kreutzmann;Julia Chevts;Ralf J. Denger;Holger Eggebrecht;Charlotte Von Engelhardt;Andreas Hagenow;Peter Heymer;Stephan Jacob;Wolfgang Jungmair;Gerd Kahrmann;Hans-Peter Kempe;Candy Von Münchhausen;Michael Lehrke;Jan Wagner;Michael Froer;Joachim Sauter;Sebastian Meyhöfer;Helga Zeller;Alexander Segner;Hans-Detlev Stahl;Joerg Steindorf;Kerstin Sturm;Thomas Schaum;Ulrich Wendisch;Evangelos Liberopoulos;Alexandra Bargiota;Konstantinos Tziomalos;Vaia Lambadiari;Emmanouil Pagkalos;Alexander Kokkinos;Georgia Argyrakopoulou;Gerasimos Siasos;Sotirios Patsilinakos;Leonidas Lanaras;Athanasios Kartalis;George Ntaios;Kimon Stamatelopoulos;Elias Tsougos;Dénes Páll;Gyozo Kocsis;Róbert Takács;Marietta Baranyai;Géza Lupkovics;Annamária Piros;László Könyves;Upendra Kaul;Sanjay Mittal;Jitendra Pal Singh Sawhney;Sandeep Garg;Ambuj Roy;Dheeraj Gandotra;Nihal Thomas;Dhiman Kahali;Rajpal K. Abhaichand;Johann Christopher;Shirish Hiremath;J Kannan;Rishi Sethi;Manoj K. Shah;Ajay Naik;G. Prafulla Kerkar;Kiron Varghese;Atul Abhyankar;Ajit Bhagwat;Gurpreet S. Wander;Arun K. Chopra;Krishna M. Parvathareddy;Sandeep Bansal;Ajay U. Mahajan;Ramesh B. Pothineni;Devang Desai;Vinod Vijan;Devendra K. Agarwal;Mahesh Fulwani;Jaspal Arneja;Piyush Desai;Vincent Maher;David Molony;Kenneth McDonald;Maria Byrne;Donal O'Shea;Seamus Sreenan;Carel Le Roux;Ofri Mosenzon;Ronen Durst;Amir Bashkin;Yael Sofer;Victor Vishlitzky;Gabriella Segal Lieberman;Michael Shechter;Dror Dicker;Taiba Zornitzki;Idit Liberty;Naim Shehadeh;Yaron Arbel;Silvio Buscemi;Uberto Pagotto;Roberto Vettor;Ferruccio Santini;Geltrude Mingrone;Francesco Dotta;Fiorenzo Cortinovis;Giulia Cogni;Simona Bo;Lucia Frittitta;A. Malavazos;Marco Bucci;Edoardo Mannucci;Paolo Sbraccia;Anna M. Colao;Maria C. Zatelli;Fabrizio Muratori;Frida Leonetti;Dario Tuccinardi;Marco Mirani;Cesare Berra;Mitsuru Ohsugi;Hideki Tanaka;Haruhiko Onaka;Atsuyuki Watanabe;Toshiyuki Sugiura;Kuniaki Morisaki;Takuya Nagano;Masayuki Doi;Masahiro Natsuaki;Naomasa Miyamoto;Kenshi Fujii;Fumiki Oh;Satoru Mitomo;Masahiro Kawanishi;Ryoji Kitamura;Hajime Maeda;Taiji Miyake;Noriyuki Kinoshita;Atsushi Sato;Yuzo Takeuchi;Osamu Ueda;Arihiro Kiyosue;Satoshi Kodera;Mamoru Manita;Yasushi Fukushima;Masaharu Kinoshita;Masahiro Yamasaki;Atsushi Sueyoshi;Toshiaki Ando;Keiichi Hanaoka;Tsuyoshi Isawa;Yoshiki Hata;Hideyuki Kunishige;Mitsutoshi Oguri;Mitsunori Abe;Takashi Matsumoto;Yasuhiro Ono;Yoshio Okada;Toshiaki Kato;Tokushi Koga;Ryoko Fujita;Tomohiro Sakamoto;Hideki Okayama;Toshiaki Kadokami;Hiroshi Yamaguchi;Takamasa Iwasawa;Itaru Maeda;Hiroki Teragawa;Hirotaka Ezaki;Arija Lace;Irina Veze;Inga Rezgale;Gustavs Latkovskis;Iveta Sime;Dace Teterovska;Gita Rancane;Irina Klavina;Liew H. Bang;Tiong K. Ong;Saravanan Krishinan;Li Y. Lee;Norsiah Ali;Anwar I. Ruhani;Zanariah Hussein;A. Rosman;Imran B. Abidin;Wan M. Wan Mohamed;Sazzli S. Kasim;Enrique C. Morales Villegas;Raymundo García Reza;José L. Arenas León;José R. Lazcano Soto;Alberto E. Bazzoni Ruiz;Pedro A. Garcia Hernandez;Silvia A. Jimenez-Ramos;Maria A. Arias Mendoza;Manuel O. De Los Rios Ibarra;Andre P. Van Beek;J. Schaap;Henk Swart;F. M. A. C. Martens;Peter Nierop;T. Vossenberg;C. Van Der Zwaan;Reinhart Dorman;Bjorn Groenemeijer;T. J. Römer;Joeran Hjelmesaeth;Serena Tonstad;Sigrun Halvorsen;Lars Gullestad;Tone Gretland Valderhaug;Hans O. Høivik;Rasmus G. Høgalmen;Ottar K. Nygård;Eva Rice;Pawel Bogdanski;Edward Franek;Grzegorz Gajos;Lucyna Ostrowska;Ewa Szyprowska;Monika Lukaszewicz;Grzegorz Kania;Grzegorz Skoczylas;Monika Kujawiak;Iwona Wozniak;Witold Chrustowski;Malgorzata Jozefowska;Agata Leksycka;Jaroslaw Jurowiecki;Wojciech Czochra;Grazyna Pulka;Agnieszka Karczmarczyk;Barbara Stogowska-Nikiciuk;Piotr Kalmucki;Maciej Beckowski;Sara França;Luisa Fonseca;Cristina Martins;Pedro Monteiro;Fausto Pinto;Nicolae Hancu;Adrian Vlad;Lavinia Pop;Adriana Onaca;Adriana Cif;Melinda Kurtinecz;Ionela M. Vladu;Ciprian Constantin;Valerica Nafornita;Cristina Toarba;Silviana Constantinescu;Rodica Avram;Georgiana Nicolescu;Bogdan Popa;Dana Cosma;Liliana Marin;Delia V. Reurean Pintilei;Magdalena Morosanu;Nicoleta M. Mîndrescu;Cristina V. Mistodie;Corin V. Badiu;Sirona Lupu;Dan Enculescu;Elena Caceaune;Georgiana Enache;Ivan G. Gordeev;Oksana Shaydyuk;Zhanna Kobalava;Tatiana Khlevchuk;Marat Ezhov;Viacheslav Mareev;Olga Vorobyeva;Tatiana Markova;Polina Ermakova;Olga O. Bolshakova;Diana Alpenidze;Konstantin Zrazhevskiy;Ruslan Sardinov;Andrey Obrezan;Alsu Zalevskaya;Olga Zagrebelnaya;Irina V. Dvoryashina;Dmitriy Platonov;Larisa Khaisheva;Elena Shutemova;Marina Y. Sergeeva Kondrachenko;Olga Smolenskaya;Lyudmila A. Suplotova;Sergey Shalaev;Olga Gilinskaya;Olga Barbarash;Vyacheslav V. Ryabov;Alla A. Boshchenko;Yulia Samoilova;Nadezhda G. Veselovskaya;Tatyana A. Lysenko;Elena A. Zhdanova;Mikhail Zykov;Lidia Belousova;Andrey B. Peskov;Irina Ipatko;Irina Gurieva;Dmitriy Ruyatkin;Elizaveta Antonova;Elena E. Kazakova;Olga Ershova;Oksana Vinogradova;Galina N. Guseva;Yulia Pergaeva;Marina Kharakhulakh;Maxim Sorokin;Inga Krivosheeva;Albert Galyavich;Tatiana Sveklina;Nebojsa Lalic;Katarina Lalic;Nemanja Djenic;Marjana Vukicevic;Edita Stokic;Milika Asanin;Goran Stankovic;Arsen Ristic;Iftikhar O. Ebrahim;Dorothea Urbach;Clive Corbett;Landman Lombard;Aysha Badat;Mohamed Fulat;Cornelia Kapp;Vuyokazi N. Bandezi;Naeem Moosa;Douwe M. De Jong;Nqoba Tsabedze;Eugene Van Der Walt;Elane Van Nieuwenhuizen;Shahid Wadvalla;Lesley Burgess;Kathleen Coetzee;Saleem Y. Dawood;Jonathan Peter;Louis Van Zyl;Nyda Fourie;Johannes J. Lombaard;Ellen M. Makotoko;Prakash Jugnundan;Zelda E. Punt;Eric Klug;Francisco Tinahones;Carmen De Pablo;Carmen De La Cuesta;Alfonso Soto González;Juan F. Merino Torres;Luis Masmiquel Comas;Margarita Rivas Fernández;Almudena Castro;Cristobal Morales Portillo;Pedro Mezquita Raya;Olga González Albarrán;Lars Rydén;Björn Eliasson;Helene Holmer;Thomas Mooe;Ken Eliasson;Carl-Johan Lindholm;Chau-Chung Wu;I-Chang Hsieh;Hung-I Yeh;Ming-En Liu;Thung-Lip Lee;Sompongse Suwanwalaikorn;Arisara Suwanagool;Dilok Piyayotai;Supawan Buranapin;Prin Vathesatogkit;Chesda Udommongkol;Nakarin Sansanayudh;Songsak Kiatchoosakun;Wanwarang Wongcharoen;Selcuk Dagdelen;Yusuf A. Sonmez;Seda Sancak;Meral Kayikcioglu;Mustafa Unubol;Ramazan Sari;Okan S. Bakiner;Ahmet Celik;Yuksel Altuntas;Dilek Gogas Yavuz;Ebru Ozpelit;Ibrahim Gul;Oner Ozdogan;Dilek Yazici;Mustafa Araz;Mine Adas;Mazhar M. Tuna;Ozlem Soyluk Selcukbiricik;Mehmet Kanadasi;Abdurrahman Oguzhan;Oleksandr Parkhomenko;Zoreslava Lysak;Leonid Rudenko;Valentyna Velychko;Olena Levchenko;Yuriy Mostovoy;Mykola Stanislavchuk;Mykola Kushnir;Ivan Vyshnyvetskyy;Tetiana Ilashchuk;Olena Buriakovska;Viktoriia Leonidova;Yulian Kyyak;Olha Horoshko;Liudmyla Todoriuk;Galyna Myshanych;John Wilding;Robert Andrews;Njaimeh Asamoah;Mark Barber;Srikanth Bellary;Andrew Broadley;Matt Capehorn;Rebecca Clark;Piers Clifford;Jeff Stoker;Steven Creely;Cuong Dang;Simon Dobson;Patrick English;Ewart Jackson-Voyzey;Danijela Tatovic;Philip Keeling;Jeffrey Khoo;Mary Lynch;Kelvin Lee;Barbara McGowan;Yaswin Beerachee;Alexander Miras;Min Myint;Sunil Nair;Neil Paul;Hermione Price;Harpal Randeva;Thozhukat Sathyapalan;Roxy Senior;Raj Sharma;Sumeet Sharma;Anna Strzelecka;Neil Swanson;Graeme Tait;Bijay Vaidya;Royce Vincent;John Wakeling;Pete Wilson;Yuk-Ki Wong;Nell Wyatt;John M. Agaiby;Amer Al-Karadsheh;Caroline Apovian;Ahmed A. Arif;Vanita R. Aroda;Heidi C. Shea;Otis Barnum;Martin Berk;Isabel Pereira;William C. Biggs;Liana Billings;Donald Brautigam;Andrew P. Brockmyre;Matthew J. Budoff

2025

Abstract

Importance The primary analysis of the SELECT randomized clinical trial suggests that semaglutide reduced the rates of cardiovascular (CV) death, myocardial infarction, and stroke in patients with established CV disease (CVD) and overweight or obesity without diabetes. However, the effect of semaglutide on hospitalizations in this population remains unknown. Objective To determine the impact of semaglutide on total hospital admissions and duration of hospital stay. Design, Setting, and Participants The SELECT trial included patients aged 45 years or older with established CVD and a body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) of 27 or higher without diabetes at 804 clinical settings across North America, South America, Europe, Asia, Africa, and Australia. Patients were randomized from October 2018 to March 2021. This prespecified exploratory analysis was conducted from February 2024 to September 2025. Interventions Once-weekly subcutaneous semaglutide, 2.4 mg, or placebo. Main Outcomes and Measures The total number of hospital admissions and days in hospital between the semaglutide and placebo groups. Results A total of 17 604 patients (median [IQR] age, 61.0 [55.0-68.0] years; 4872 female patients [27.7%]; median [IQR] BMI, 32.1 [29.7-35.7]) were followed up for a median (IQR) period of 41.8 (33.0-47.0) months. There were 11 287 hospital admissions. The number of total hospitalizations was lower in the semaglutide group vs placebo for any indication (18.3 vs 20.4 admissions per 100 patient-years; mean ratio [MR], 0.90; 95% CI, 0.85-0.95; P < .001) and for serious adverse events (15.2 vs 17.1 admissions per 100 patient-years; MR, 0.89; 95% CI, 0.84-0.94; P < .001). The number of days hospitalized for any indication per 100 patient-years was lower in the semaglutide group vs placebo (157.2 vs 176.2 days; rate ratio [RR], 0.89; 95% CI, 0.82-0.98; P = .01), as well as hospitalizations for serious adverse events (137.6 vs 153.9 days; RR, 0.89; 95% CI, 0.81-0.98; P = .02). No heterogeneity was observed for the reduction of hospital admissions with semaglutide in selected subgroups, including BMI, age, and sex. Conclusions and Relevance In this prespecified exploratory analysis of the SELECT randomized clinical trial, the trial cohort had a high rate of hospital admissions. Treatment with once-weekly semaglutide was associated with significant reductions in hospital admissions and overall time spent in hospital, extending its benefits beyond CV risk reduction.

Scheda breve

Scheda completa

Scheda completa (DC)

	Settori scientifico-disciplinari dell'articolo (validi dal 09/05/2024)
	
				Settore MEDS-08/C - Scienza dell'alimentazione e delle tecniche dietetiche applicate
			
	Data di pubblicazione
	
				2025
			
	Data ahead of print o data di stampa
	
				dic-2025
			
	Rivista in ANCE
	
				JAMA CARDIOLOGY
			
	DOI
	
				https://dx.doi.org/10.1001/jamacardio.2025.4824
			
	Tipologia
	
				Article (author)
			
	Appare nelle tipologie:
	
				01 - Articolo su periodico

File in questo prodotto:

File	Dimensione	Formato
jamacardiology_nicholls_2025_oi_250074_1766159001.00666 (1).pdf accesso riservato Tipologia: Publisher's version/PDF Licenza: Nessuna licenza Dimensione 417.46 kB Formato Adobe PDF Visualizza/Apri Richiedi una copia	417.46 kB	Adobe PDF	Visualizza/Apri Richiedi una copia

Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1214215

Citazioni

ND

0

0

ND

IRIS Institutional Research Information System - AIR Archivio Istituzionale della Ricerca