Semaglutide Offers Early Cardiovascular Protection for High-Risk Patients

Recent findings from a secondary analysis of the Semaglutide and Cardiovascular Outcomes (SELECT) trial suggest that semaglutide, a medication initially approved for type 2 diabetes and obesity management, may provide rapid early protection against heart disease in adults with overweight or obesity and existing cardiovascular risk factors. Presented at the European Congress on Obesity (ECO25) in Malaga, Spain, the study highlights that significant reductions in major cardiovascular events can be observed within the first three to six months of treatment, even before notable weight loss or full dosage titration.

The analysis involved 17,604 participants aged 45 and older from across 41 countries, all receiving weekly injections of semaglutide or placebo. Results indicated a 38% reduction in major adverse cardiovascular events (MACE) at three months, increasing to a 41% reduction at six months, compared to placebo. Remarkably, these benefits appeared early, prior to substantial weight loss and before patients reached the full target dose of 2.4 mg.

Dr. Jorge Plutzky, a leading author and director of Preventive Cardiology at Brigham and Women's Hospital, explained that these early effects could involve mechanisms such as reductions in inflammation, blood sugar levels, blood pressure, or direct cardiovascular actions of the drug. Notably, participants were already on other cardio-protective therapies, suggesting semaglutide offers additional benefits.

Originally developed for diabetes, semaglutide mimics incretin hormones, which regulate blood sugar and promote satiety, leading to weight loss. While previous research has demonstrated its cardiovascular benefits in diabetic patients, the new findings suggest potential for heart disease prevention in non-diabetic individuals at high risk, particularly those with prior cardiovascular events like heart attacks or strokes.

It is important to note that the SELECT trial was not designed as a primary prevention study; all participants had existing cardiovascular conditions. However, the early and significant reduction in cardiovascular events points to the potential of semaglutide as an important adjunct therapy for high-risk populations. Further research is needed to fully understand the mechanisms behind these early benefits and the long-term implications.

These promising results underscore the evolving role of GLP-1 receptor agonists like semaglutide in cardiovascular protection, beyond their metabolic effects, offering new hope in the fight against heart disease for patients with obesity and cardiovascular risk factors.