Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes

Lincoff, A.M.; Brown-Frandsen, K.; Colhoun, H.M.; Deanfield, J.; Emerson, S.S.; Esbjerg, S.; Hardt-Lindberg, S.; Hovingh, G.K.; Kahn, S.E.; Kushner, R.F.; Lingvay, I.; Oral, T.K.; Michelsen, M.M.; Plutzky, J.; Tornøe, C.W.; Ryan,; Donna, H.; Porto, A.; Villarino, A.; Chacon, C.; Zaidman, C.J.; Farias, E.; Duronto, E.; Farias, J.M.; Casas, M.; Oviedo, A.; Sanabria, H.D.; Perez Terns, P.; Amerena, J.; Leung, M.; Colquhoun, D.M.; Purnell, P.; William, M.; Abhayaratna, W.P.; Morbey, C.; Nicholls, S.; Cross, D.; Arstall, M.; Kostner, K.; Shirazi, M.; Ekinci, E.I.; Toplak, H.; Hanusch, U.; Aigner, E.; Ludvik, B.; Kautzky-Willer, A.; Prager, R.; Kaser, S.; Vanduynhoven, P.; Verwerft, J.; Vrolix, M.; De Pauw, M.; Vercammen, C.; Van De Borne, P.; Prakova-Teneva, Z.R.; Runev, N.; Petrov, I.; Milanova, M.; Postadzhiyan, A.; Gelev, V.; Vasileva, S.P.; Georgiev, B.; Katova, T.; Tokmakova, M.; Goudev, A.; Vassilev, D.; Minkova, D.A.; Tisheva-Gospodinova, S.; Yotov, Y.; Rossi, P.; Nicolau, J.C.; Maia, L.N.; Saraiva, J.F.; Kormann, A.P.; Arantes, F.B.; Kaiser, S.E.; Leite, S.O.; Cercato, C.; Fonseca, A.G.; Kurtz Lisboa, H.R.; Turatti, L.A.; Franco, D.R.; Farsky, P.S.; Ritt, L.E.; Poirier, P.; Pandey, A.S.; St-Maurice, F.; Bourgeois, R.; Robitaille, Y.; Constance, C.; Filteau, P.; Verma, S.; Vijayaraghavan, R.; Weisnagel, J.; Egan, A.; Hartleib, M.; Pedersen, S.; Tellier, G.; Peters, K.; Cha, J.Y.; Langlois, M.F.; Garg, N.; Datta, S.; Salter, T.; Spaic, T.; Lau, D.; Tsoukas, G.M.; Stewart, J.; Vale, N.; Rabasa-Lhoret, R.; Vallieres, G.; Allison, R.; Martinez Cano, C.A.; Accini Mendoza, J.L.; Botero Lopez, R.; Urina Triana, M.A.; Rodriguez Plazas, J.A.; Cadena Bonfanti, A.J.; Malecha, J.; Klimsa, Z.; Linhart, A.; Koleckar, P.; Cermak, O.; Kuchar, L.; Stasek, J.; Malicherova, E.; Vesela, A.; Haluzik, M.; Jungmair, W.; Stahl, H.D.; Appel, K.F.; Al-Zoebi, A.; Eggebrecht, H.; Wagner, J.; Zeller, H.; Kreutzmann, K.; Meyhöfer, S.; Von Engelhardt, C.; Sauter, J.; Jacob, S.; Sturm, K.; Kahrmann, G.; Von Münchhausen, C.; Chevts, J.; Hagenow, A.; Froer, M.; Segner, A.; Lehrke, M.; Schaum, T.; Heymer, P.; Wendisch, U.; Kempe, H.P.; Denger, R.J.; Steindorf, J.; Bøttcher, M.; Mæng, M.; Gislason, G.; Egstrup, K.; Hove, J.D.; Jensen, S.E.; Nibouche, D.E.; Chettibi, M.; Hammoudi, N.; Tinahones, F.; Morales Portillo, C.; De La Cuesta, C.; Soto González, A.; Rivas Fernández, M.; Castro, A.; González Albarrán, O.; Mezquita Raya, P.; De Pablo, C.; Merino Torres, J.F.; Masmiquel Comas, L.; Lakka, T.; Ahtiainen, P.; Pietilä, M.; Ilveskoski, E.; Ukkola, O.; Niskanen, L.; Keski-Opas, T.; Cariou, B.; Demicheli, T.; Petit, C.; Kerneis, M.; Schiele, F.; Thuan, J.F.; Gatta-Cherifi, B.; Verges, B.; Hulot, J.S.; Stephan, D.; Serusclat, P.; Steg, G.; Barone Rochette, G.; Keeling, P.; Sathyapalan, T.; Randeva, H.; Wong, Y.K.; Miras, A.; Clifford, P.; Tatovic, D.; Andrews, R.; Strzelecka, A.; Asamoah, N.; Barber, M.; Broadley, A.; Lee, K.; Paul, N.; Vaidya, B.; Wyatt, N.; Price, H.; Vincent, R.; Wakeling, J.; Clark, R.; Creely, S.; English, P.; Sharma, S.; Capehorn, M.; Lang, C.; Beerachee, Y.; Sharma, R.; Wilding, J.; Wilson, P.; Lynch, M.; Mcgowan, B.; Myint, M.; Dang, C.; Khoo, J.; Senior, R.; Swanson, N.; Bellary, S.; Nair, S.; Stoker, J.; Dobson, S.; Jackson-Voyzey, E.; Tait, G.; Kartalis, A.; Tsougos, E.; Patsilinakos, S.; Tziomalos, K.; Lambadiari, V.; Kokkinos, A.; Argyrakopoulou, G.; Lanaras, L.; Liberopoulos, E.; Siasos, G.; Stamatelopoulos, K.; Ntaios, G.; Pagkalos, E.; Ruzic, A.; Kruljac, I.; Milicic, D.; Canecki Varzic, S.; Budincevic, H.; Fuckar, K.; Delic-Brkljacic, D.; Páll, D.; Lupkovics, G.; Piros, A.; Könyves, L.; Takács, R.; Baranyai, M.; Desai, P.; Abhyankar, A.; Parvathareddy, K.M.; Agarwal, D.K.; Jitendra Pal Singh, S.; Sethi, R.; Wander, G.S.; Prafulla, K.G.; Desai, D.; Kaul, U.; Vijan, V.; Thomas, N.; Christopher, J.; Hiremath, S.; Bhagwat, A.; Bansal, S.; Mahajan, A.; Mittal, S.; Ajay, N.; Abhaichand, R.K.; Fulwani, M.; Garg, S.; Gandotra, D.; Shah, M.K.; Kahali, D.; Varghese, K.; Pothineni, R.B.; Arneja, J.; Ambuj, R.; Kannan, J.; Maher, V.; Byrne, M.; Sreenan, S.; Molony, D.; Le Roux, C.; Mcdonald, K.; Durst, R.; Shechter, M.; Arbel, Y.; Shehadeh, N.; Zornitzki, T.; Sofer, Y.; Liberty, I.; Vishlitzky, V.; Mosenzon, O.; Bashkin, A.; Segal Lieberman, G.; Dicker, D.; Santini, F.; Leonetti, F.; Buscemi, S.; Mingrone, G.; Pagotto, U.; Malavazos, A.; Tuccinardi, D.; Cogni, G.; Bo, S.; Mannucci, E.; Sbraccia, P.; Frittitta, L.; Zatelli, M.C.; Bucci, M.; Berra, C.; Vettor, R.; Dotta, F.; Cortinovis, F.; Colao, A.M.; Mirani, M.; Muratori, F.; Manita, M.; Doi, M.; Oh, F.; Sato, A.; Takeuchi, Y.; Sueyoshi, A.; Hata, Y.; Miyamoto, N.; Fujii, K.; Mitomo, S.; Hanaoka, K.; Okada, Y.; Ezaki, H.; Maeda, I.; Kawanishi, M.; Kitamura, R.; Miyake, T.; Kiyosue, A.; Fukushima, Y.; Isawa, T.; Watanabe, A.; Ueda, O.; Kunishige, H.; Ono, Y.; Kadokami, T.; Iwasawa, T.; Onaka, H.; Sugiura, T.; Kinoshita, N.; Ando, T.; Oguri, M.; Matsumoto, T.; Kato, T.; Koga, T.; Fujita, R.; Yamaguchi, H.; Teragawa, H.; Morisaki, K.; Yamasaki, M.; Okayama, H.; Nagano, T.; Abe, M.; Tanaka, H.; Natsuaki, M.; Sakamoto, T.; Ohsugi, M.; Maeda, H.; Kodera, S.; Kinoshita, M.; Klavina, I.; Lace, A.; Latkovskis, G.; Rezgale, I.; Rancane, G.; Veze, I.; Teterovska, D.; Sime, I.; Garcia Hernandez, P.A.; García Reza, R.; Arias Mendoza, M.A.; Arenas León, J.L.; Bazzoni Ruiz, A.E.; Morales Villegas, E.C.; Lazcano Soto, J.R.; Jimenez-Ramos, S.A.; De Los Rios Ibarra, M.O.; Ong, T.K.; Abidin, I.B.Z.; Kasim, S.S.; Ali, N.; Wan Mohamed, W.M.I.; Lee, L.Y.; Krishinan, S.; Ruhani, A.I.; Hussein, Z.; Rosman, A.; Bang, L.H.; Van Der Zwaan, C.; Vossenberg, T.; Martens, F.M.A.C.; Groenemeijer, B.; Nierop, P.; Dorman, R.; Van Beek, A.P.; Swart, H.; Schaap, J.; Römer, T.J.; Høivik, H.O.; Tonstad, S.; Hjelmesaeth, J.; Gullestad, L.; Nygård, O.K.; Høgalmen, R.G.; Rice, E.; Halvorsen, S.; Gretland Valderhaug, T.; Czochra, W.; Wozniak, I.; Bogdanski, P.; Franek, E.; Ostrowska, L.; Kania, G.; Karczmarczyk, A.; Gajos, G.; Stogowska-Nikiciuk, B.; Chrustowski, W.; Skoczylas, G.; Jurowiecki, J.; Kujawiak, M.; Leksycka, A.; Szyprowska, E.; Beckowski, M.; Kalmucki, P.; Lukaszewicz, M.; Pulka, G.; Jozefowska, M.; Monteiro, P.; França, S.; Fonseca, L.; Martins, C.; Pinto, F.; Ferreira, D.; Enculescu, D.; Marin, L.; Constantin, C.; Enache, G.; Morosanu, M.; Reurean Pintilei, D.V.; Mistodie, C.V.; Constantinescu, S.; Nicolescu, G.; Onaca, A.; Nafornita, V.; Pop, L.; Cif, A.; Popa, B.; Cosma, D.; Kurtinecz, M.; Toarba, C.; Lupu, S.; Caceaune, E.; Mîndrescu, N.M.; Hancu, N.; Vladu, I.M.; Avram, R.; Badiu, C.V.; Vlad, A.; Ermakova, P.; Barbarash, O.; Ruyatkin, D.; Ezhov, M.; Ryabov, V.V.; Zrazhevskiy, K.; Sergeeva-Kondrachenko, M.Y.; Gurieva, I.; Kobalava, Z.; Zykov, M.; Khaisheva, L.; Gordeev, I.G.; Zhdanova, E.A.; Sardinov, R.; Zalevskaya, A.; Boshchenko, A.A.; Shutemova, E.; Samoilova, Y.; Lysenko, T.A.; Sorokin, M.; Suplotova, L.A.; Bolshakova, O.O.; Dvoryashina, I.V.; Smolenskaya, O.; Veselovskaya, N.G.; Belousova, L.; Antonova, E.; Peskov, A.B.; Shaydyuk, O.; Markova, T.; Obrezan, A.; Sveklina, T.; Shalaev, S.; Gilinskaya, O.; Khlevchuk, T.; Galyavich, A.; Mareev, V.; Guseva, G.N.; Zagrebelnaya, O.; Vorobyeva, O.; Krivosheeva, I.; Alpenidze, D.; Platonov, G.; Vinogradova, O.; Pergaeva, Y.; Kazakova, E.E.; Ipatko, I.; Ershova, O.; Kharakhulakh, M.; Lalic, N.; Stankovic, G.; Ristic, A.; Djenic, N.; Stokic, E.; Lalic, K.; Asanin, M.; Vukicevic, M.; Eliasson, B.; Rydén, L.; Eliasson, K.; Lindholm, C.J.; Holmer, H.; Mooe, T.; Piyayotai, D.; Udommongkol, C.; Vathesatogkit, P.; Suwanagool, A.; Kiatchoosakun, S.; Suwanwalaikorn, S.; Sansanayudh, N.; Buranapin, S.; Wongcharoen, W.; Bakiner, O.S.; Celik, A.; Sari, R.; Altuntas, Y.; Kayikcioglu, M.; Gogas, D.; Ozpelit, E.; Tuna, M.M.; Araz, M.; Oguzhan, A.; Gul, I.; Ozdogan, O.; Unubol, M.; Sonmez, Y.A.; Sancak, S.; Adas, M.; Kanadasi, M.; Dagdelen, S.; Yazici, D.; Soyluk Selcukbiricik, O.; Liu, M.E.; C. C., W.; Yeh, H.I.; Hsieh, I.C.; Lee, T.L.; Rudenko, L.; Myshanych, G.; Parkhomenko, O.; Ilashchuk, T.; Vyshnyvetskyy, I.; Leonidova, V.; Horoshko, O.; Buriakovska, O.; Velychko, V.; Kushnir, M.; Stanislavchuk, M.; Kyyak, Y.; Todoriuk, L.; Levchenko, O.; Lysak, Z.; Mostovoy, Y.; Serota, H.; Doran, J.A.; Concha, M.; Lupovitch, S.; Fordan, S.; Samal, A.K.; Desouza, C.V.; Rasouli, N.; Smith, S.K.; Shneker, A.; Harris, B.; Kandath, D.; Alkaradsheh, A.; Clark, W.; Carr, J.; Anderson, R.J.; Tran, H.; Jardula, M.F.; Marso, S.P.; O'Donnell, P.; Snyder, B.; Wynne, A.; Koren, M.J.; Harris, K.; Buse, J.B.; Lingvay, I.; Murray, R.; Swenson, B.P.; Bitar, F.; Singh, N.; Wallace, J.; Cannon, K.; Murthy, A.; Bakdash, W.; Iteld, B.; Logemann, T.; Busch, R.; Correia, M.; Usdan, L.; Bernstein, M.; Jabbar, D.; Mcgrew, F.; Sultan, S.; Allison, D.C.; Garvey, W.T.; Zacher, J.; Sivalingam, K.; Robbins, D.; Aroda, V.R.; Brautigam, D.; Jackson, R.A.; Riley, T.H.; Sangrigoli, R.; Baum, S.; Mills, R.E.; Reyes, C.R.; Morawski, E.J.; Abou Assi, H.; Berk, M.; Tripathy, D.; Billings, L.; Lewis, M.; Hewitt, E.; Zarich, S.; Ariani, M.; Siddiqui, I.A.; Mcpherson, D.D.; Herzog, W.; Levins, P.; Soufer, J.; Carrillo-Jimenez, R.; Pereira, I.; Daboul, N.Y.; Buljubasic, N.; Geller, S.A.; Rosen, G.; Wenocur, H.S.; Audish, H.; Dela Llana, A.; Biggs, W.C.; Calinescu, C.V.; Agha, M.; Brodie, S.K.; Bays, H.E.; Budoff, M.J.; Kastelic, R.; Ledesma, G.N.; Mclean, B.K.; Powell, T.; Sathananthan, A.; Sigal, F.; Wilson, J.P.; Lash, J.; Sidey, J.; Buynak, R.; Pereira, E.S.; Barnum, O.; Burguera, B.; Joyce, J.M.; Nayak, B.M.; Lenzmeier, T.; Siraj, E.; Warren, M.L.; Weintraub, H.; Dukes, C.E.; Houser, P.M.; Kereiakes, D.J.; Lofton, H.; Raikhel, M.A.; Weber, B.; Opsahl, P.J.; Block, B.; Beshay, I.; Khadra, S.; Brockmyre, A.P.; Gandy, W.H.; Risser, J.A.; Jaffrani, N.A.; Sotolongo, C.; Heimer, B.; Iranmanesh, A.; Arif, A.A.; Lovell, C.F.; Philis-Tsimikas, A.; Garza, J.C.; Potu, R.P.; Shah, N.; Spriggs, D.; Agaiby, J.M.; Liu, J.; Purighalla, R.S.; Oaks, J.B.; Saggar, S.; Patel, M.B.; Qureshi, M.; Solano, R.; Scott, J.; Cornett, G.M.; Lepor, N.; Nakhle, S.N.; Miller, G.; Pop-Busui, R.; Trusau, A.; Shea, H.C.; Call, R.S.; Hartman, A.N.; Condit, J.; Pullman, J.; Rodbard, H.W.; Martinez, C.; Geohas, J.G.; Issa, M.; Sofley, C.W.; Chaicha-Brom, T.; Ward, K.; Lorraine, R.; Ghazi, A.; Klein, E.J.; Klonoff, D.; Ong, S.; Vo, A.; Aronne, L.J.; Gambill, M.L.; Bhan, A.; Sargeant, W.; Still, C.; Morin, R.P.; Delibasic, M.; Breton, C.F.; Perez-Vargas, E.A.; Oneil, P.; Bosworth, H.; Gilbert, M.P.; Ruffin, O.; Folkens, E.M.; Meyers, P.; Wierum, C.; Jastreboff, A.; Davuluri, A.K.; Ahmed, A.; Gorton, S.C.; Finneran, M.P.; Herman, L.; Jerkins, T.; Munir, I.; Tamirisa, A.; Curtis, B.; Kubicki, T.; Johnson, W.; Yuan, Q.; Krishnasamy, S.S.; Welker, J.; Chandra, S.; Buffman, B.; Perkelvald, A.; Pratley, R.E.; Shlesinger, Y.; Poremba, J.; Levy, L.J.; D'Agostino, R.; Friedman, K.; Ebrahim, I.O.; Badat, A.; Burgess, L.; Fourie, N.; Urbach, D.; Fulat, M.; Van Nieuwenhuizen, E.; Tsabedze, N.; Coetzee, K.; Klug, E.; Makotoko, E.M.; Moosa, N.; De Jong, D.M.; Van Der Walt, E.; Van Zyl, L.; Corbett, C.; Kapp, C.; Wadvalla, S.; Dawood, S.Y.; Punt, Z.E.; Lombard, L.; Lombaard, J.J.; Bandezi, V.N.; Peter, J.; Jugnundan, P.

doi:10.1056/nejmoa2307563

BACKGROUND Semaglutide, a glucagon-like peptide-1 receptor agonist, has been shown to reduce the risk of adverse cardiovascular events in patients with diabetes. Whether semaglutide can reduce cardiovascular risk associated with overweight and obesity in the absence of diabetes is unknown. METHODS In a multicenter, double-blind, randomized, placebo-controlled, event-driven superiority trial, we enrolled patients 45 years of age or older who had preexisting cardiovascular disease and a body-mass index (the weight in kilograms divided by the square of the height in meters) of 27 or greater but no history of diabetes. Patients were randomly assigned in a 1:1 ratio to receive once-weekly subcutaneous semaglutide at a dose of 2.4 mg or placebo. The primary cardiovascular end point was a composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke in a time-to-first-event analysis. Safety was also assessed. RESULTS A total of 17,604 patients were enrolled; 8803 were assigned to receive semaglutide and 8801 to receive placebo. The mean (±SD) duration of exposure to semaglutide or placebo was 34.2±13.7 months, and the mean duration of follow-up was 39.8±9.4 months. A primary cardiovascular end-point event occurred in 569 of the 8803 patients (6.5%) in the semaglutide group and in 701 of the 8801 patients (8.0%) in the placebo group (hazard ratio, 0.80; 95% confidence interval, 0.72 to 0.90; P<0.001). Adverse events leading to permanent discontinuation of the trial product occurred in 1461 patients (16.6%) in the semaglutide group and 718 patients (8.2%) in the placebo group (P<0.001). CONCLUSIONS In patients with preexisting cardiovascular disease and overweight or obesity but without diabetes, weekly subcutaneous semaglutide at a dose of 2.4 mg was superior to placebo in reducing the incidence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke at a mean follow-up of 39.8 months. (Funded by Novo Nordisk; SELECT ClinicalTrials.gov number, NCT03574597.)

Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes / L. A. Michael, B. Kirstine, C. Helen M., D. John, E. Scott S., E. Sille, H. Søren, H. G. Kees, K. Steven E., K. Robert F., L. Ildiko, O. Tugce K., M. Marie M., P. Jorge, T. Christoffer W., Ryan, D. H., A. Porto, A. Villarino, C. Chacon, C.J. Zaidman, E. Farias, E. Duronto, J.M. Farias, M. Casas, A. Oviedo, H.D. Sanabria, P. Perez Terns, J. Amerena, M. Leung, D.M. Colquhoun, P. Purnell, M. William, W.P. Abhayaratna, C. Morbey, S. Nicholls, D. Cross, M. Arstall, K. Kostner, M. Shirazi, E.I. Ekinci, H. Toplak, U. Hanusch, E. Aigner, B. Ludvik, A. Kautzky-Willer, R. Prager, S. Kaser, P. Vanduynhoven, J. Verwerft, M. Vrolix, M. De Pauw, C. Vercammen, P. Van De Borne, Z.R. Prakova-Teneva, N. Runev, I. Petrov, M. Milanova, A. Postadzhiyan, V. Gelev, S.P. Vasileva, B. Georgiev, T. Katova, M. Tokmakova, A. Goudev, D. Vassilev, D.A. Minkova, S. Tisheva-Gospodinova, Y. Yotov, P. Rossi, J.C. Nicolau, L.N. Maia, J.F. Saraiva, A.P. Kormann, F.B. Arantes, S.E. Kaiser, S.O. Leite, C. Cercato, A.G. Fonseca, H.R. Kurtz Lisboa, L.A. Turatti, D.R. Franco, P.S. Farsky, L.E. Ritt, P. Poirier, A.S. Pandey, F. St-Maurice, R. Bourgeois, Y. Robitaille, C. Constance, P. Filteau, S. Verma, R. Vijayaraghavan, J. Weisnagel, A. Egan, M. Hartleib, S. Pedersen, G. Tellier, K. Peters, J.Y. Cha, M.F. Langlois, N. Garg, S. Datta, T. Salter, T. Spaic, D. Lau, G.M. Tsoukas, J. Stewart, N. Vale, R. Rabasa-Lhoret, G. Vallieres, R. Allison, C.A. Martinez Cano, J.L. Accini Mendoza, R. Botero Lopez, M.A. Urina Triana, J.A. Rodriguez Plazas, A.J. Cadena Bonfanti, J. Malecha, Z. Klimsa, A. Linhart, P. Koleckar, O. Cermak, L. Kuchar, J. Stasek, E. Malicherova, A. Vesela, M. Haluzik, W. Jungmair, H.D. Stahl, K.F. Appel, A. Al-Zoebi, H. Eggebrecht, J. Wagner, H. Zeller, K. Kreutzmann, S. Meyhöfer, C. Von Engelhardt, J. Sauter, S. Jacob, K. Sturm, G. Kahrmann, C. Von Münchhausen, J. Chevts, A. Hagenow, M. Froer, A. Segner, M. Lehrke, T. Schaum, P. Heymer, U. Wendisch, H.P. Kempe, R.J. Denger, J. Steindorf, M. Bøttcher, M. Mæng, G. Gislason, K. Egstrup, J.D. Hove, S.E. Jensen, D.E. Nibouche, M. Chettibi, N. Hammoudi, F. Tinahones, C. Morales Portillo, C. De La Cuesta, A. Soto González, M. Rivas Fernández, A. Castro, O. González Albarrán, P. Mezquita Raya, C. De Pablo, J.F. Merino Torres, L. Masmiquel Comas, T. Lakka, P. Ahtiainen, M. Pietilä, E. Ilveskoski, O. Ukkola, L. Niskanen, T. Keski-Opas, B. Cariou, T. Demicheli, C. Petit, M. Kerneis, F. Schiele, J.F. Thuan, B. Gatta-Cherifi, B. Verges, J.S. Hulot, D. Stephan, P. Serusclat, G. Steg, G. Barone Rochette, P. Keeling, T. Sathyapalan, H. Randeva, Y.K. Wong, A. Miras, P. Clifford, D. Tatovic, R. Andrews, A. Strzelecka, N. Asamoah, M. Barber, A. Broadley, K. Lee, N. Paul, B. Vaidya, N. Wyatt, H. Price, R. Vincent, J. Wakeling, R. Clark, S. Creely, P. English, S. Sharma, M. Capehorn, C. Lang, Y. Beerachee, R. Sharma, J. Wilding, P. Wilson, M. Lynch, B. Mcgowan, M. Myint, C. Dang, J. Khoo, R. Senior, N. Swanson, S. Bellary, S. Nair, J. Stoker, S. Dobson, E. Jackson-Voyzey, G. Tait, A. Kartalis, E. Tsougos, S. Patsilinakos, K. Tziomalos, V. Lambadiari, A. Kokkinos, G. Argyrakopoulou, L. Lanaras, E. Liberopoulos, G. Siasos, K. Stamatelopoulos, G. Ntaios, E. Pagkalos, A. Ruzic, I. Kruljac, D. Milicic, S. Canecki Varzic, H. Budincevic, K. Fuckar, D. Delic-Brkljacic, D. Páll, G. Lupkovics, A. Piros, L. Könyves, R. Takács, M. Baranyai, P. Desai, A. Abhyankar, K.M. Parvathareddy, D.K. Agarwal, S. Jitendra Pal Singh, R. Sethi, G.S. Wander, K.G. Prafulla, D. Desai, U. Kaul, V. Vijan, N. Thomas, J. Christopher, S. Hiremath, A. Bhagwat, S. Bansal, A. Mahajan, S. Mittal, N. Ajay, R.K. Abhaichand, M. Fulwani, S. Garg, D. Gandotra, M.K. Shah, D. Kahali, K. Varghese, R.B. Pothineni, J. Arneja, R. Ambuj, J. Kannan, V. Maher, M. Byrne, S. Sreenan, D. Molony, C. Le Roux, K. Mcdonald, R. Durst, M. Shechter, Y. Arbel, N. Shehadeh, T. Zornitzki, Y. 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Garcia Hernandez, R. García Reza, M.A. Arias Mendoza, J.L. Arenas León, A.E. Bazzoni Ruiz, E.C. Morales Villegas, J.R. Lazcano Soto, S.A. Jimenez-Ramos, M.O. De Los Rios Ibarra, T.K. Ong, I.B.Z. Abidin, S.S. Kasim, N. Ali, W.M.I. Wan Mohamed, L.Y. Lee, S. Krishinan, A.I. Ruhani, Z. Hussein, A. Rosman, L.H. Bang, C. Van Der Zwaan, T. Vossenberg, F.M.A.C. Martens, B. Groenemeijer, P. Nierop, R. Dorman, A.P. Van Beek, H. Swart, J. Schaap, T.J. Römer, H.O. Høivik, S. Tonstad, J. Hjelmesaeth, L. Gullestad, O.K. Nygård, R.G. Høgalmen, E. Rice, S. Halvorsen, T. Gretland Valderhaug, W. Czochra, I. Wozniak, P. Bogdanski, E. Franek, L. Ostrowska, G. Kania, A. Karczmarczyk, G. Gajos, B. Stogowska-Nikiciuk, W. Chrustowski, G. Skoczylas, J. Jurowiecki, M. Kujawiak, A. Leksycka, E. Szyprowska, M. Beckowski, P. Kalmucki, M. Lukaszewicz, G. Pulka, M. Jozefowska, P. Monteiro, S. França, L. Fonseca, C. Martins, F. Pinto, D. Ferreira, D. Enculescu, L. Marin, C. Constantin, G. Enache, M. Morosanu, D.V. Reurean Pintilei, C.V. Mistodie, S. Constantinescu, G. Nicolescu, A. Onaca, V. Nafornita, L. Pop, A. Cif, B. Popa, D. Cosma, M. Kurtinecz, C. Toarba, S. Lupu, E. Caceaune, N.M. Mîndrescu, N. Hancu, I.M. Vladu, R. Avram, C.V. Badiu, A. Vlad, P. Ermakova, O. Barbarash, D. Ruyatkin, M. Ezhov, V.V. Ryabov, K. Zrazhevskiy, M.Y. Sergeeva-Kondrachenko, I. Gurieva, Z. Kobalava, M. Zykov, L. Khaisheva, I.G. Gordeev, E.A. Zhdanova, R. Sardinov, A. Zalevskaya, A.A. Boshchenko, E. Shutemova, Y. Samoilova, T.A. Lysenko, M. Sorokin, L.A. Suplotova, O.O. Bolshakova, I.V. Dvoryashina, O. Smolenskaya, N.G. Veselovskaya, L. Belousova, E. Antonova, A.B. Peskov, O. Shaydyuk, T. Markova, A. Obrezan, T. Sveklina, S. Shalaev, O. Gilinskaya, T. Khlevchuk, A. Galyavich, V. Mareev, G.N. Guseva, O. Zagrebelnaya, O. Vorobyeva, I. Krivosheeva, D. Alpenidze, G. Platonov, O. Vinogradova, Y. Pergaeva, E.E. Kazakova, I. Ipatko, O. Ershova, M. Kharakhulakh, N. Lalic, G. Stankovic, A. Ristic, N. Djenic, E. Stokic, K. Lalic, M. Asanin, M. Vukicevic, B. Eliasson, L. Rydén, K. Eliasson, C.J. Lindholm, H. Holmer, T. Mooe, D. Piyayotai, C. Udommongkol, P. Vathesatogkit, A. Suwanagool, S. Kiatchoosakun, S. Suwanwalaikorn, N. Sansanayudh, S. Buranapin, W. Wongcharoen, O.S. Bakiner, A. Celik, R. Sari, Y. Altuntas, M. Kayikcioglu, D. Gogas, E. Ozpelit, M.M. Tuna, M. Araz, A. Oguzhan, I. Gul, O. Ozdogan, M. Unubol, Y.A. Sonmez, S. Sancak, M. Adas, M. Kanadasi, S. Dagdelen, D. Yazici, O. Soyluk Selcukbiricik, M.E. Liu, C.C. Wu, H.I. Yeh, I.C. Hsieh, T.L. Lee, L. Rudenko, G. Myshanych, O. Parkhomenko, T. Ilashchuk, I. Vyshnyvetskyy, V. Leonidova, O. Horoshko, O. Buriakovska, V. Velychko, M. Kushnir, M. Stanislavchuk, Y. Kyyak, L. Todoriuk, O. Levchenko, Z. Lysak, Y. Mostovoy, H. Serota, J.A. Doran, M. Concha, S. Lupovitch, S. Fordan, A.K. Samal, C.V. Desouza, N. Rasouli, S.K. Smith, A. Shneker, B. Harris, D. Kandath, A. Alkaradsheh, W. Clark, J. Carr, R.J. Anderson, H. Tran, M.F. Jardula, S.P. Marso, P. 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Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes

Lincoff, A. Michael;Brown-Frandsen, Kirstine;Colhoun, Helen M.;Deanfield, John;Emerson, Scott S.;Esbjerg, Sille;Hardt-Lindberg, Søren;Hovingh, G. Kees;Kahn, Steven E.;Kushner, Robert F.;Lingvay, Ildiko;Oral, Tugce K.;Michelsen, Marie M.;Plutzky, Jorge;Tornøe, Christoffer W.;Ryan;Donna H.;A. Porto;A. Villarino;C. Chacon;C. J. Zaidman;E. Farias;E. Duronto;J. M. Farias;M. Casas;A. Oviedo;H. D. Sanabria;P. Perez Terns;J. Amerena;M. Leung;D. M. Colquhoun;P. Purnell;M. William;W. P. Abhayaratna;C. Morbey;S. Nicholls;D. Cross;M. Arstall;K. Kostner;M. Shirazi;E. I. Ekinci;H. Toplak;U. Hanusch;E. Aigner;B. Ludvik;A. Kautzky-Willer;R. Prager;S. Kaser;P. Vanduynhoven;J. Verwerft;M. Vrolix;M. De Pauw;C. Vercammen;P. Van De Borne;Z. R. Prakova-Teneva;N. Runev;I. Petrov;M. Milanova;A. Postadzhiyan;V. Gelev;S. P. Vasileva;B. Georgiev;T. Katova;M. Tokmakova;A. Goudev;D. Vassilev;D. A. Minkova;S. Tisheva-Gospodinova;Y. Yotov;P. Rossi;J. C. Nicolau;L. N. Maia;J. F. Saraiva;A. P. Kormann;F. B. Arantes;S. E. Kaiser;S. O. Leite;C. Cercato;A. G. Fonseca;H. R. Kurtz Lisboa;L. A. Turatti;D. R. Franco;P. S. Farsky;L. E. Ritt;P. Poirier;A. S. Pandey;F. St-Maurice;R. Bourgeois;Y. Robitaille;C. Constance;P. Filteau;S. Verma;R. Vijayaraghavan;J. Weisnagel;A. Egan;M. Hartleib;S. Pedersen;G. Tellier;K. Peters;J. Y. Cha;M. F. Langlois;N. Garg;S. Datta;T. Salter;T. Spaic;D. Lau;G. M. Tsoukas;J. Stewart;N. Vale;R. Rabasa-Lhoret;G. Vallieres;R. Allison;C. A. Martinez Cano;J. L. Accini Mendoza;R. Botero Lopez;M. A. Urina Triana;J. A. Rodriguez Plazas;A. J. Cadena Bonfanti;J. Malecha;Z. Klimsa;A. Linhart;P. Koleckar;O. Cermak;L. Kuchar;J. Stasek;E. Malicherova;A. Vesela;M. Haluzik;W. Jungmair;H. D. Stahl;K. F. Appel;A. Al-Zoebi;H. Eggebrecht;J. Wagner;H. Zeller;K. Kreutzmann;S. Meyhöfer;C. Von Engelhardt;J. Sauter;S. Jacob;K. Sturm;G. Kahrmann;C. Von Münchhausen;J. Chevts;A. Hagenow;M. Froer;A. Segner;M. Lehrke;T. Schaum;P. Heymer;U. Wendisch;H. P. Kempe;R. J. Denger;J. Steindorf;M. Bøttcher;M. Mæng;G. Gislason;K. Egstrup;J. D. Hove;S. E. Jensen;D. E. Nibouche;M. Chettibi;N. Hammoudi;F. Tinahones;C. Morales Portillo;C. De La Cuesta;A. Soto González;M. Rivas Fernández;A. Castro;O. González Albarrán;P. Mezquita Raya;C. De Pablo;J. F. Merino Torres;L. Masmiquel Comas;T. Lakka;P. Ahtiainen;M. Pietilä;E. Ilveskoski;O. Ukkola;L. Niskanen;T. Keski-Opas;B. Cariou;T. Demicheli;C. Petit;M. Kerneis;F. Schiele;J. F. Thuan;B. Gatta-Cherifi;B. Verges;J. S. Hulot;D. Stephan;P. Serusclat;G. Steg;G. Barone Rochette;P. Keeling;T. Sathyapalan;H. Randeva;Y. K. Wong;A. Miras;P. Clifford;D. Tatovic;R. Andrews;A. Strzelecka;N. Asamoah;M. Barber;A. Broadley;K. Lee;N. Paul;B. Vaidya;N. Wyatt;H. Price;R. Vincent;J. Wakeling;R. Clark;S. Creely;P. English;S. Sharma;M. Capehorn;C. Lang;Y. Beerachee;R. Sharma;J. Wilding;P. Wilson;M. Lynch;B. McGowan;M. Myint;C. Dang;J. Khoo;R. Senior;N. Swanson;S. Bellary;S. Nair;J. Stoker;S. Dobson;E. Jackson-Voyzey;G. Tait;A. Kartalis;E. Tsougos;S. Patsilinakos;K. Tziomalos;V. Lambadiari;A. Kokkinos;G. Argyrakopoulou;L. Lanaras;E. Liberopoulos;G. Siasos;K. Stamatelopoulos;G. Ntaios;E. Pagkalos;A. Ruzic;I. Kruljac;D. Milicic;S. Canecki Varzic;H. Budincevic;K. Fuckar;D. Delic-Brkljacic;D. Páll;G. Lupkovics;A. Piros;L. Könyves;R. Takács;M. Baranyai;P. Desai;A. Abhyankar;K. M. Parvathareddy;D. K. Agarwal;S. Jitendra Pal Singh;R. Sethi;G. S. Wander;K. G. Prafulla;D. Desai;U. Kaul;V. Vijan;N. Thomas;J. Christopher;S. Hiremath;A. Bhagwat;S. Bansal;A. Mahajan;S. Mittal;N. Ajay;R. K. Abhaichand;M. Fulwani;S. Garg;D. Gandotra;M. K. Shah;D. Kahali;K. Varghese;R. B. Pothineni;J. Arneja;R. Ambuj;J. Kannan;V. Maher;M. Byrne;S. Sreenan;D. Molony;C. Le Roux;K. McDonald;R. Durst;M. Shechter;Y. Arbel;N. Shehadeh;T. Zornitzki;Y. Sofer;I. Liberty;V. Vishlitzky;O. Mosenzon;A. Bashkin;G. Segal Lieberman;D. Dicker;F. Santini;F. Leonetti;S. Buscemi;G. Mingrone;U. Pagotto;A. Malavazos;D. Tuccinardi;G. Cogni;S. Bo;E. Mannucci;P. Sbraccia;L. Frittitta;M. C. Zatelli;M. Bucci;C. Berra;R. Vettor;F. Dotta;F. Cortinovis;A. M. Colao;M. Mirani;F. Muratori;M. Manita;M. Doi;F. Oh;A. Sato;Y. Takeuchi;A. Sueyoshi;Y. Hata;N. Miyamoto;K. Fujii;S. Mitomo;K. Hanaoka;Y. Okada;H. Ezaki;I. Maeda;M. Kawanishi;R. Kitamura;T. Miyake;A. Kiyosue;Y. Fukushima;T. Isawa;A. Watanabe;O. Ueda;H. Kunishige;Y. Ono;T. Kadokami;T. Iwasawa;H. Onaka;T. Sugiura;N. Kinoshita;T. Ando;M. Oguri;T. Matsumoto;T. Kato;T. Koga;R. Fujita;H. Yamaguchi;H. Teragawa;K. Morisaki;M. Yamasaki;H. Okayama;T. Nagano;M. Abe;H. Tanaka;M. Natsuaki;T. Sakamoto;M. Ohsugi;H. Maeda;S. Kodera;M. Kinoshita;I. Klavina;A. Lace;G. Latkovskis;I. Rezgale;G. Rancane;I. Veze;D. Teterovska;I. Sime;P. A. Garcia Hernandez;R. García Reza;M. A. Arias Mendoza;J. L. Arenas León;A. E. Bazzoni Ruiz;E. C. Morales Villegas;J. R. Lazcano Soto;S. A. Jimenez-Ramos;M. O. De Los Rios Ibarra;T. K. Ong;I. B. Z. Abidin;S. S. Kasim;N. Ali;W. M. I. Wan Mohamed;L. Y. Lee;S. Krishinan;A. I. Ruhani;Z. Hussein;A. Rosman;L. H. Bang;C. Van Der Zwaan;T. Vossenberg;F. M. A. C. Martens;B. Groenemeijer;P. Nierop;R. Dorman;A. P. Van Beek;H. Swart;J. Schaap;T. J. Römer;H. O. Høivik;S. Tonstad;J. Hjelmesaeth;L. Gullestad;O. K. Nygård;R. G. Høgalmen;E. Rice;S. Halvorsen;T. Gretland Valderhaug;W. Czochra;I. Wozniak;P. Bogdanski;E. Franek;L. Ostrowska;G. Kania;A. Karczmarczyk;G. Gajos;B. Stogowska-Nikiciuk;W. Chrustowski;G. Skoczylas;J. Jurowiecki;M. Kujawiak;A. Leksycka;E. Szyprowska;M. Beckowski;P. Kalmucki;M. Lukaszewicz;G. Pulka;M. Jozefowska;P. Monteiro;S. França;L. Fonseca;C. Martins;F. Pinto;D. Ferreira;D. Enculescu;L. Marin;C. Constantin;G. Enache;M. Morosanu;D. V. Reurean Pintilei;C. V. Mistodie;S. Constantinescu;G. Nicolescu;A. Onaca;V. Nafornita;L. Pop;A. Cif;B. Popa;D. Cosma;M. Kurtinecz;C. Toarba;S. Lupu;E. Caceaune;N. M. Mîndrescu;N. Hancu;I. M. Vladu;R. Avram;C. V. Badiu;A. Vlad;P. Ermakova;O. Barbarash;D. Ruyatkin;M. Ezhov;V. V. Ryabov;K. Zrazhevskiy;M. Y. Sergeeva-Kondrachenko;I. Gurieva;Z. Kobalava;M. Zykov;L. Khaisheva;I. G. Gordeev;E. A. Zhdanova;R. Sardinov;A. Zalevskaya;A. A. Boshchenko;E. Shutemova;Y. Samoilova;T. A. Lysenko;M. Sorokin;L. A. Suplotova;O. O. Bolshakova;I. V. Dvoryashina;O. Smolenskaya;N. G. Veselovskaya;L. Belousova;E. Antonova;A. B. Peskov;O. Shaydyuk;T. Markova;A. Obrezan;T. Sveklina;S. Shalaev;O. Gilinskaya;T. Khlevchuk;A. Galyavich;V. Mareev;G. N. Guseva;O. Zagrebelnaya;O. Vorobyeva;I. Krivosheeva;D. Alpenidze;G. Platonov;O. Vinogradova;Y. Pergaeva;E. E. Kazakova;I. Ipatko;O. Ershova;M. Kharakhulakh;N. Lalic;G. Stankovic;A. Ristic;N. Djenic;E. Stokic;K. Lalic;M. Asanin;M. Vukicevic;B. Eliasson;L. Rydén;K. Eliasson;C. J. Lindholm;H. Holmer;T. Mooe;D. Piyayotai;C. Udommongkol;P. Vathesatogkit;A. Suwanagool;S. Kiatchoosakun;S. Suwanwalaikorn;N. Sansanayudh;S. Buranapin;W. Wongcharoen;O. S. Bakiner;A. Celik;R. Sari;Y. Altuntas;M. Kayikcioglu;D. Gogas;E. Ozpelit;M. M. Tuna;M. Araz;A. Oguzhan;I. Gul;O. Ozdogan;M. Unubol;Y. A. Sonmez;S. Sancak;M. Adas;M. Kanadasi;S. Dagdelen;D. Yazici;O. Soyluk Selcukbiricik;M. E. Liu;C. C. Wu;H. I. Yeh;I. C. Hsieh;T. L. Lee;L. Rudenko;G. Myshanych;O. Parkhomenko;T. Ilashchuk;I. Vyshnyvetskyy;V. Leonidova;O. Horoshko;O. Buriakovska;V. Velychko;M. Kushnir;M. Stanislavchuk;Y. Kyyak;L. Todoriuk;O. Levchenko;Z. Lysak;Y. Mostovoy;H. Serota;J. A. Doran;M. Concha;S. Lupovitch;S. Fordan;A. K. Samal;C. V. Desouza;N. Rasouli;S. K. Smith;A. Shneker;B. Harris;D. Kandath;A. AlKaradsheh;W. Clark;J. Carr;R. J. Anderson;H. Tran;M. F. Jardula;S. P. Marso;P. O'Donnell;B. Snyder;A. Wynne;M. J. Koren;K. Harris;J. B. Buse;I. Lingvay;R. Murray;B. P. Swenson;F. Bitar;N. Singh;J. Wallace;K. Cannon;A. Murthy;W. Bakdash;B. Iteld;T. Logemann;R. Busch;M. Correia;L. Usdan;M. Bernstein;D. Jabbar;F. McGrew;S. Sultan;D. C. Allison;W. T. Garvey;J. Zacher;K. Sivalingam;D. Robbins;V. R. Aroda;D. Brautigam;R. A. Jackson;T. H. Riley;R. Sangrigoli;S. Baum;R. E. Mills;C. R. Reyes;E. J. Morawski;H. Abou Assi;M. Berk;D. Tripathy;L. Billings;M. Lewis;E. Hewitt;S. Zarich;M. Ariani;I. A. Siddiqui;D. D. McPherson;W. Herzog;P. Levins;J. Soufer;R. Carrillo-Jimenez;I. Pereira;N. Y. Daboul;N. Buljubasic;S. A. Geller;G. Rosen;H. S. Wenocur;H. Audish;A. Dela Llana;W. C. Biggs;C. V. Calinescu;M. Agha;S. K. Brodie;H. E. Bays;M. J. Budoff;R. Kastelic;G. N. Ledesma;B. K. McLean;T. Powell;A. Sathananthan;F. Sigal;J. P. Wilson;J. Lash;J. Sidey;R. Buynak;E. S. Pereira;O. Barnum;B. Burguera;J. M. Joyce;B. M. Nayak;T. Lenzmeier;E. Siraj;M. L. Warren;H. Weintraub;C. E. Dukes;P. M. Houser;D. J. Kereiakes;H. Lofton;M. A. Raikhel;B. Weber;P. J. Opsahl;B. Block;I. Beshay;S. Khadra;A. P. Brockmyre;W. H. Gandy;J. A. Risser;N. A. Jaffrani;C. Sotolongo;B. Heimer;A. Iranmanesh;A. A. Arif;C. F. Lovell;A. Philis-Tsimikas;J. C. Garza;R. P. Potu;N. Shah;D. Spriggs;J. M. Agaiby;J. Liu;R. S. Purighalla;J. B. Oaks;S. Saggar;M. B. Patel;M. Qureshi;R. Solano;J. Scott;G. M. Cornett;N. Lepor;S. N. Nakhle;G. Miller;R. Pop-Busui;A. Trusau;H. C. Shea;R. S. Call;A. N. Hartman;J. Condit;J. Pullman;H. W. Rodbard;C. Martinez;J. G. Geohas;M. Issa;C. W. Sofley;T. Chaicha-Brom;K. Ward;R. Lorraine;A. Ghazi;E. J. Klein;D. Klonoff;S. Ong;A. Vo;L. J. Aronne;M. L. Gambill;A. Bhan;W. Sargeant;C. Still;R. P. Morin;M. Delibasic;C. F. Breton;E. A. Perez-Vargas;P. Oneil;H. Bosworth;M. P. Gilbert;O. Ruffin;E. M. Folkens;P. Meyers;C. Wierum;A. Jastreboff;A. K. Davuluri;A. Ahmed;S. C. Gorton;M. P. Finneran;L. Herman;T. Jerkins;I. Munir;A. Tamirisa;B. Curtis;T. Kubicki;W. Johnson;Q. Yuan;S. S. Krishnasamy;J. Welker;S. Chandra;B. Buffman;A. Perkelvald;R. E. Pratley;Y. Shlesinger;J. Poremba;L. J. Levy;R. D'Agostino;K. Friedman;I. O. Ebrahim;A. Badat;L. Burgess;N. Fourie;D. Urbach;M. Fulat;E. Van Nieuwenhuizen;N. Tsabedze;K. Coetzee;E. Klug;E. M. Makotoko;N. Moosa;D. M. De Jong;E. Van Der Walt;L. Van Zyl;C. Corbett;C. Kapp;S. Wadvalla;S. Y. Dawood;Z. E. Punt;L. Lombard;J. J. Lombaard;V. N. Bandezi;J. Peter;P. Jugnundan

2023

Abstract

BACKGROUND Semaglutide, a glucagon-like peptide-1 receptor agonist, has been shown to reduce the risk of adverse cardiovascular events in patients with diabetes. Whether semaglutide can reduce cardiovascular risk associated with overweight and obesity in the absence of diabetes is unknown. METHODS In a multicenter, double-blind, randomized, placebo-controlled, event-driven superiority trial, we enrolled patients 45 years of age or older who had preexisting cardiovascular disease and a body-mass index (the weight in kilograms divided by the square of the height in meters) of 27 or greater but no history of diabetes. Patients were randomly assigned in a 1:1 ratio to receive once-weekly subcutaneous semaglutide at a dose of 2.4 mg or placebo. The primary cardiovascular end point was a composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke in a time-to-first-event analysis. Safety was also assessed. RESULTS A total of 17,604 patients were enrolled; 8803 were assigned to receive semaglutide and 8801 to receive placebo. The mean (±SD) duration of exposure to semaglutide or placebo was 34.2±13.7 months, and the mean duration of follow-up was 39.8±9.4 months. A primary cardiovascular end-point event occurred in 569 of the 8803 patients (6.5%) in the semaglutide group and in 701 of the 8801 patients (8.0%) in the placebo group (hazard ratio, 0.80; 95% confidence interval, 0.72 to 0.90; P<0.001). Adverse events leading to permanent discontinuation of the trial product occurred in 1461 patients (16.6%) in the semaglutide group and 718 patients (8.2%) in the placebo group (P<0.001). CONCLUSIONS In patients with preexisting cardiovascular disease and overweight or obesity but without diabetes, weekly subcutaneous semaglutide at a dose of 2.4 mg was superior to placebo in reducing the incidence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke at a mean follow-up of 39.8 months. (Funded by Novo Nordisk; SELECT ClinicalTrials.gov number, NCT03574597.)

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	Settori scientifico-disciplinari dell'articolo (validi dal 09/05/2024)
	
				Settore MEDS-07/B - Malattie dell'apparato cardiovascolare
			
	Data di pubblicazione
	
				2023
			
	Rivista in ANCE
	
				THE NEW ENGLAND JOURNAL OF MEDICINE
			
	DOI
	
				https://dx.doi.org/10.1056/nejmoa2307563
			
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				01 - Articolo su periodico

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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1220316

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