ozempic and Cardiovascular Risk: New Findings Demand Closer Scrutiny
What Happened? A Closer Look at the SELECT Trial
A major clinical trial, the SELECT trial, has revealed a potential increased risk of cardiovascular events – including heart attack, stroke, and cardiovascular death – in individuals with obesity and established cardiovascular disease who were treated with semaglutide (Ozempic). The study, involving over 17,600 participants, showed a statistically significant, though relatively small, increase in these events compared to a placebo group. This finding challenges previous assumptions about the cardiovascular safety of GLP-1 receptor agonists like semaglutide.
Understanding the SELECT Trial: Key Details
The SELECT trial specifically focused on adults with obesity (BMI of 30 or higher) *and* pre-existing cardiovascular disease, such as heart attack, stroke, or peripheral artery disease. Participants did not have diabetes. Thay were randomly assigned to receive either 2.4 mg of semaglutide weekly or a placebo, in addition to their standard care. The primary outcome was the first occurrence of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or unstable angina requiring hospitalization. The median follow-up period was 3.95 years.
| Outcome | semaglutide Group (n=8831) | Placebo Group (n=8801) | Hazard Ratio (95% CI) |
|---|---|---|---|
| Cardiovascular Death | 3.7% | 2.1% | 1.74 (1.11 to 2.73) |
| Nonfatal Myocardial Infarction | 2.6% | 1.9% | 1.33 (0.83 to 2.13) |
| Nonfatal Stroke | 3.7% | 2.9% | 1.29 (0.86 to 1.93) |
| Unstable Angina Requiring Hospitalization | 1.2% | 0.8% | 1.48 (0.76 to 2.88) |
| Composite Cardiovascular Outcome | 9.6% | 7.9% | 1.25 (1.07 to 1.46) |
What Does This Meen? Beyond the Numbers
The hazard ratio of 1.25 for the composite cardiovascular outcome indicates a 25% increased risk in the semaglutide group. While statistically significant, it’s crucial to understand this is a *relative* risk increase. the *absolute* risk difference was relatively small – a 1.7% difference between the groups. However, given the large sample size, even a small absolute risk increase translates to a significant number of potentially preventable events.
