Forecasting cardiovascular risk reduction with semaglutide in overweight and obese with heart disease: a nationwide cohort study

The Semaglutide Effects on Heart Disease and Stroke in Patients with Overweight or Obesity (SELECT) trial,1 which enrolled 17 604 participants aged ≥45 years with overweight or obesity and established cardiovascular disease (CVD) and without diabetes, recently met its primary endpoint: once-weekly semaglutide (2.4 mg) resulted in a 20% relative risk reduction (RRR) in major adverse cardiovascular events (MACEs) defined as the first occurrence of cardiovascular (CV) death, non-fatal myocardial infarction (MI), or non-fatal stroke.2 Based on the results of SELECT, the U.S. Food and Drug Administration has since approved an expanded label indication for semaglutide (2.4 mg) to include CV risk reduction. However, the potential effect of semaglutide on population-level CV risk is unknown. Using the Danish nationwide health registries, we sought to quantify the size of the SELECT-eligible population and to forecast the effects of nationwide semaglutide implementation on the risk of MACE in this population.