by Elana Gotkine

Semaglutide reduces cardiovascular events, regardless of baseline glycated hemoglobin (HbA_1c), among people with overweight or obesity and established atherosclerotic cardiovascular disease, according to a study published online June 22 in Diabetes Care.

Ildiko Lingvay, M.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues randomly assigned people with overweight or obesity and atherosclerotic cardiovascular disease without diabetes to weekly semaglutide 2.4 mg or placebo to examine the cardiovascular effects of semaglutide. Outcomes, including first major adverse cardiovascular event (MACE), which included cardiovascular mortality, nonfatal myocardial infarction, or stroke, were examined by baseline HbA_1c subgroup and categories of HbA_1c change from baseline to 20 weeks.

Baseline HbA_1c was <5.7%, 5.7 to <6.0%, and 6.0 to <6.5% for 33.5, 34.6, and 31.9% of the 17,604 participants, respectively. The researchers found that across baseline HbA_1c groups, cardiovascular risk reduction was not different with semaglutide versus placebo; for all end points, except all-cause mortality, the risk reduction was similar. Across subgroups of HbA_1c change, cardiovascular outcomes were also consistent.

"We showed that even people with completely normal blood sugar have the same benefits in reducing MACEs as people with blood sugar levels in the prediabetes range," Lingvay said in a statement. "This is very important information that helps us understand which patients might benefit from the cardiovascular risk-lowering effects of this medicine."

Several authors disclosed ties to pharmaceutical companies, including Novo Nordisk, which manufactures semaglutide and funded the study.

More information: Ildiko Lingvay et al, Semaglutide and Cardiovascular Outcomes by Baseline HbA_1c and Change in HbA_1c in People With Overweight or Obesity but Without Diabetes in SELECT, Diabetes Care (2024). DOI: 10.2337/dc24-0764

Shivani Misra, Deciphering the Effects of Semaglutide Across the Glycemic Spectrum, Diabetes Care (2024). DOI: 10.2337/dci24-0057

Journal information: Diabetes Care 

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