Semaglutide and Hospitalizations in Patients With Obesity and Established Cardiovascular Disease

作者：S. Nicholls, Donna H. Ryan, John Deanfield, Daniel Ferreira, Chim C. Lang, A. Michael Lincoff, Ildiko Lingvay, Christopher Lübker, Paula Pérez Terns, S. Munkgaard Rasmussen, SIGNE STENSEN, Peter Weeke, Steven E. Kahn, SELECT Trial Investigators, Djamel E. Nibouche, Mohamed Chettibi, Naima Hammoudi, Alejandro Porto, Alejandra Oviedo, Hugo D. Sanabria, Marcelo Martín Casas, Eduardo Farias, Ernesto Duronto, Carolina Chacón, Adriana Villarino, Javier M. Farias, Cesar Javier Zaidman, Claire Morbey, David M. Colquhoun, Elif I. Ekinci, Melissa Leung, Maged William, Karam Kostner, Mitra Shirazi, David Cross, John Amerena, Peter Purnell, Margaret Arstall, Walter P. Abhayaratna, Hermann Toplak, Rudolf Prager, Bernhard Ludvik, ALEXANDRA KAUTZKY-WILLER, Ursula Hanusch, Elmar Aigner, Susanne Käser, Michel De Pauw, Philippe Vanduynhoven, Philippe Van De Borne, Chris Vercammen, Jan Verwerft, Mathias Vrolix, Luiz Alberto Andreotti Turatti, José Francisco Kerr Saraiva, Cíntia Cercato, Adrian Kormann, Silmara Oliveira Leite, Paulo Rossi, Flávia B. Arantes, Lilia N. Maia, Sérgio Kaiser, Alberto Fonseca, Hugo Lisboa, DENISE FRANCO, José Carlos Nicolau, Pedro Sílvio Farsky, Luiz Eduardo Fontelles Ritt, Assen Goudev, Dobrin Vassilev, Nikolay Runev, B. Georgiev, Tzvetana Katova, Ivo Petrov, Валери Гелев, Maria Milanova, Arman Postadzhiyan, Mariya Tokmakova, Yoto Yotov, Snezhanka T. Tisheva-Gospodinova, Dotska Minkova, Zhulieta R. Prakova-Teneva, Svetla Vasileva, Alan Egan, George Tsoukas, Subodh Verma, Ronald Bourgeois, Pierre Filteau, Ram Vijayaraghavan, Michael Hartleib, Tamara Spaic, John Stewart, Amritanshu- S. Pandey, Remi Rabasa-Lhoret, François St-Maurice, James W. Bo y, SUE PEDERSEN, Roy Allison, Paul Poirier, Marie‐France Langlois, David Lau, Yves Robitaille, John Weisnagel, Christian Constance, Sudip Datta, Naveen Garg, Tim Salter, Noah Vale, Gerald Vallieres, Karina Peters, Guy Tellier, Rodrigo Botero Lopez, Miguel A. Urina Triana, Alberto J. Cadena Bonfanti, Jose L. Accini Mendoza, Jaime A. Rodriguez Plazas, Carlos A. Martínez Cano, Davor Milicic, Silvija Canecki Varzic, Hrvoje Budincevic, Diana Delic-Brkljacic, Alen Ruzic, Ivan Kruljac, Krunoslav Fuckar, Ales Linhart, Jan Malecha, Ondrej Cermak, Pavel Koleckar, Zdeněk Klimsa, Ladislav Kuchař, Emilia Malicherova, Josef Stasek, Martin Haluzik, Alica Veselá, Michael Mæng, Jens Dahlgaard Hove, Kenneth Egstrup, Svend E. Jensen, Gunnar Gislason, Morten Bôttcher, Mikko Pietilä, Erkki Ilveskoski, Timo Lakka, Petteri Ahtiainen, Olavi Ukkola, Leo Niskanen, Tiina Keski-Opas, François Schiele, Dominique Stéphan, Catherine Petit, Mathieu Kerneis, Bertrand CARIOU, Gabriel Steg, Bruno Vergès, Jean‐Sébastien Hulot, T Demichéli, Jean-Francois Thuan, Gilles Barone Rochette, Gatta-Cherifi Blandine, Pierre Serusclat, Ayham Al-Zoebi, Karl-Friedrich Appel, Kristin Kreutzmann, Julia Chevts, Ralf J. Denger, Holger Eggebrecht, Charlotte von Engelhardt, Andreas Hagenow, Peter Heymer, Stephan Jacob, Wolfgang Jungmair, Gerd Kahrmann, Hans-Peter Kempe, Candy von Münchhausen, Michael Lehrke, Jan Wagner, Michael Froer, Joachim Sauter, Sebastian M. Meyhöfer, Helga Zeller, Alexander Segner, Hans-Detlev Stahl, Joerg Steindorf, K. Sturm, Thomas Schaum, Ulrich Wendisch, Evangelos Liberopoulos, Αlexandra Bargiota, Κωνσταντίνος Τζιόμαλος, Vaia Lambadiari, Emmanouil Pagkalos, Alexander Kokkinos, Georgia Argyrakopoulou, Gerasimos Siasos, Sotirios Patsilinakos, Leonidas Lanaras, Athanasios Kartalis, George Ntaios, Kimon Stamatelopoulos, Elias Tsougos, Dénes Páll, Gyozo Kocsis, Róbert Takács, Marietta Baranyai, Géza Lupkovics, Annamária Piros, L. Könyves, Upendra Kaul, Sanjay Mittal, Sawhney Jitendra Pal Singh, Sandeep Garg, Roy Ambuj, Dheeraj Gandotra, Nihal Thomas, Dhiman Kahali, Rajpal K. Abhaichand, Johann Christopher, Shirish Hiremath, J Kannan, Rishi Sethi, Manoj K. Shah, Naik Ajay, Kerkar Prafulla, Kiron Varghese, Atul D Abhyankar, Ajit Bhagwat, Gurpreet Singh Wander, Arun Chopra, Krishna M. Parvathareddy, Sandeep Bansal, Ajay U. Mahajan, Ramesh Babu Pothineni, Devang Desai, Vinod Vijan, Devendra K. Agarwal, Mahesh Fulwani, Jaspal Arneja, Piyush Desai, Vincent Maher, David Molony, Kenneth McDonald, M. M. Byrne, Donal O'shea, Seamus Sreenan, Carel Le Roux, Ofri Mosenzon, Ronen Durst, Amir Bashkin, Yael Sofer, Victor Vishlitzky, G. Lieberman, Michael Shechter, Dror Dicker, Taiba Zornitzki, Idit F. Liberty, Naim Shehadeh, Yaron Arbel, Silvio Buscemi, Uberto Pagotto, Roberto Vettor, Ferruccio Santini, Geltrude Mingrone, Francesco Dotta, F. Cortinovis, Giulia Cogni, Simona Bo, Lucia Frittitta, Alexis Elias Malavazos, Marco Bucci, Edoardo Mannucci, Paolo Sbraccia, A. Colao, Maria Chiara Zatelli, F Muratori, Frida Leonetti, DARIO TUCCINARDI, Marco Mirani, Cesare Berra, Mitsuru Ohsugi, Hideki Tanaka, Haruhiko Onaka, Atsuyuki Watanabe, Toshiyuki Sugiura, Kuniaki Morisaki, Takuya Nagano, Masayuki Doi, Masahiro Natsuaki, Naomasa Miyamoto, Kenshi Fujii, Fumiki Oh, Satoru Mitomo, Masahiro Kawanishi, Ryoji Kitamura, Hajime Maeda, Taiji Miyake, Noriyuki Kinoshita, Atsushi Satō, Yuzo Takeuchi, Osamu Ueda, Arihiro Kiyosue, Satoshi Kodera, Mamoru Manita, Yasushi Fukushima, Masaharu Kinoshita, Masahiro Yamasaki, Atsushi Sueyoshi, Toshiaki Ando, Keiichi Igarashi Hanaoka, Tsuyoshi Isawa, Yoshiki Hata, H Kunishige, Mitsutoshi Oguri, Mitsunori Abe, Takashi Matsumoto, Yasuhiro Ono, Yoshio Okada, Toshiaki Kato, Tokushi Koga, Ryoko Fujita, Tomohiro Sakamoto, Hideki Okayama, Toshiaki Kadokami, Hiroshi Yamaguchi, Takamasa Iwasawa, Itaru Maeda, Hiroki Teragawa, Hirotaka Ezaki, Arija Lace, Irina Veze, Inga Rezgale, Gustavs Latkovskis, Iveta Sime, Dace Teterovska, Gita Rancane, Irina Klavina, Liew H. Bang, Tiong K. Ong, Saravanan Krishinan, Li Yuan Lee, Norsiah Ali, Anwar I. Ruhani, Zanariah Hussein, Dr A. Rosman, Imran B. Abidin, Wan M. Wan Mohamed, Sazzli S. Kasim, Enrique C. Morales Villegas, Raymundo García Reza, José L. Arenas León, José R. Soto, Alberto E. Bazzoni Ruiz, Pedro A. Garcia Hernandez, Silvia A. Jimenez-Ramos, Maria A. Arias Mendoza, Manuel Odin de Los Rios Ibarra, Andre P. Van Beek, J. Schaap, Henk P. Swart, F.M.A.C. Martens, Peter R Nierop, T. Vossenberg, C. Van Der Zwaan, Reinhart Dorman, Björn E. Groenemeijer, T.J. Römer, Joeran Hjelmesaeth, Serena Tonstad, Sigrun Halvorsen, Lars Gullestad, Tone Gretland Valderhaug, Hans Olav Høivik, Rasmus G. Høgalmen, Ottar K. Nygård, Eva Rice, Pawel Bogdanski, Edward Franek, Grzegorz Gajos, Lucyna Ostrowska, Ewa Szyprowska, Monika Lukaszewicz, Grzegorz Kania, Grzegorz Skoczylas, Monika Kujawiak, Iwona Wozniak, Witold Chrustowski, Malgorzata Jozefowska, Agata Leksycka, Jaroslaw Jurowiecki, Wojciech Czochra, Grażyna Pulka, Agnieszka Karczmarczyk, Barbara Stogowska-Nikiciuk, Piotr Kałmucki, Maciej Bęćkowski, Sara França, Luísa Fonseca, Cristina Sarmento Pontes Martins, Pedro Monteiro, Fausto Pinto, Nicolae Hâncu, Adrian Vlad, Lavinia Pop, Adriana Onaca, Adriana Cif, Melinda Kurtinecz, Ionela M. Vladu, Ciprian Constantin, Valerica Nafornita, Cristina Toarba, Silviana Constantinescu, R Avram, Georgiana Nicolescu, Bogdan Popa, Dana Cosma, Liliana M. Marín, Delia V. Reurean Pintilei, Magdalena Morosanu, Nicoleta M. Mîndrescu, Cristina Mistodie, Corin V. Badiu, Sirona Lupu, Dan Enculescu, Elena Caceaune, Georgiana Enache, Ivan G. Gordeev, Oksana Shaydyuk, Zhanna Kobalava, Tatiana Khlevchuk, М. В. Ежов, Viacheslav Mareev, Olga Vorobyeva, Т. Н. Маркова, Polina Ermakova, Olga O. Bolshakova, Diana Alpenidze, Konstantin Zrazhevskiy, Ruslan Sardinov, Andrey G. Obrezan, Alsu Gafurovna Zalevskaya, Olga A. Zagrebelnaya, I. V. Dvoryashina, Dmitriy Platonov, Л. А. Хаишева, Е. А. Шутемова, Marina Y. Sergeeva-Kondrachenko, O. G. Smolenskaya, Lyudmila A. Suplotova, Sergey Shalaev, Olga Gilinskaya, Olga Barbarash, V. V. Ryabov, Alla A. Boshchenko, Ю. Г. Самойлова, N. G. Veselovskaya, Tatyana Lysenko, Elena Zhdanova, Mikhail Zykov, Lidia Belousova, А. Б. Песков, Irina Ipatko, Irina Gurieva, D. S. Ruyatkin, Е. Е. Антонова, Elena Kazakova, О. Б. Ершова, Oksana Vinogradova, Galina N. Guseva, Yulia Pergaeva, M. I. Kharakhulakh, Maxim Sorokin, И. А. Кривошеева, А. S. Galyavich, Т. С. Свеклина, Nebojsa M. Lalic, Katarina Lalić, Nemanja Djenic, Marjana Vukičević, Edita Stokić, Ašanin Milika, Goran Stanković, Ristic Arsen, Iftikhar O Ebrahim, Dorothea Urbach, Clive Corbett, Landman Lombard, Aysha Badat, Mohamed Fulat, Cornelia Kapp, Vuyokazi N. Bandezi, Naeem Moosa, Douwe De Jong, Nqoba Tsabedze, Eugene van der Walt, Elane van Nieuwenhuizen, Shahid Wadvalla, Lesley Burgess, Kathleen Coetzee, Saleem Dawood, Jonny Peter, Louis Van Zyl, Nyda Fourie, Johannes Lombaard, Ellen M. Makotoko, Prakash Jugnundan, Zelda Punt, Eric Klug, Francisco José Tinahones, Carmen de Pablo, Carmen de la Cuesta, Alfonso González, Juan F. Merino Torres, Luis Masmiquel Comas, Margarita Fernández, Almudena Castro, Cristobal Morales Portillo, Pedro Mezquita Raya, Olga González Albarrán, Lars Rydén, Björn Eliasson, Helene Holmer, Thomas Mooe, Ken Eliasson, Carl-Johan Lindholm, Chau-Chung Wu, I-Chang Hsieh, Hung-I Yeh, Ming-En Liu, T.-Y. Lee, Sompongse Suwanwalaikorn, Arisara Suwanagool, Dilok Piyayotai, Supawan Buranapin, Prin Vathesatogkit, Chesda Udommongkol, Nakarin Sansanayudh, Songsak Kiatchoosakun, Wanwarang Wongcharoen, Selçuk Dağdelen, Yusuf A. Sonmez, Seda Sancak, Meral L Kayikcioglu, Mustafa Ünübol, Ramazan Sari, Okan BAKINER, Ahmet Celik, Yüksel Altuntaş, Dilek Gogaş Yavuz, Ebru Ozpelit, Ibrahim Gul, Öner Özdoğan, Dilek Yazici, Mustafa Araz, Mine Adaş, Mazhar M. Tuna, Özlem Soyluk Selçukbiricik, Mehmet Kanadaşı, Abdurrahman Oğuzhan, Oleksandr Parkhomenko, Zoreslava Lysak, Leonid Rudenko, V. I. Velychko, Olena Levchenko, Yuriy Mostovoy, Mykola Stanislavchuk, Mykola Kushnir, Ivan Vyshnyvetskyy, Tetiana Ilashchuk, Olena Buriakovska, Viktoriia Leonidova, Yulian Kyyak, Olha Horoshko, Liudmyla Todoriuk, Galyna Myshanych, John Wilding, Robert Andrews, N?jaimeh Asamoah, Mark Barber, Srikanth Bellary, A Broadley, Matt Capehorn, Rebecca Clark, Piers Clifford, Jeff Stoker, S. J. Creely, Cuong Dang, Simon Dobson, Patrick English, Ewart Jackson-Voyzey, Danijela Tatović, Philip Keeling, Jeffrey Khoo, Mary Lynch, Kelvin Lee, Barbara Mcgowan, Yaswin Beerachee, Alexander Miras, Min Myint, Sunil Nair, Neil Paul, Hermione Price, Harpal Randeva, Thozhukat Sathyapalan, Roxy Senior, Raj Sharma, Sumeet Sharma, Anna Strzelecka, Neil Swanson, Graeme W. Tait, Bijay Vaidya, Royce Vincent, John Wakeling, Pete Wilson, Yuk-ki Wong, Nell Wyatt, John Agaiby, Amer Al-Karadsheh, Caroline Apovian, Ahmed A. Arif, Vanita R. Aroda, Heidi Shea, Otis Barnum, Martin R. Berk, Isabel Pereira, William Biggs, Liana Billings, Donald Brautigam, Andrew Brockmyre, Matthew J. Budoff, Barry Buffman, Bartolomé Burguera, Robert Busch, John Buse J.B. Buse, Robert S. Call, Kevin Cannon, Brian Curtis, Ronald H. Chochinov, Cornell Calinescu, Wayne Clark, Matthew Lewis, Bradley P. Swenson, George Mitchell Cornett, Nizar Y. Daboul, Cyrus Desouza, Nediljka Buljubasíc, Matthew P. Finneran, Steven Fordan, Jr. W. Gandy, W. Timothy Garvey, S Geller, Jeffrey G. Geohas, Matthew P. Gilbert, Carl Dukes, Aaron Hartman, Lee Herman, Patricia Houser, Moises Issa, Richard A. Jackson, Michael F. Jardula, Terri Jerkins, John M. Joyce, Richard Kastelic, Bindu Nayak, Dean J. Kereiakes, E. Klein, Ted Kubicki, Gilbert N. Ledesma, Omari Ruffin, Thomas Lenzmeier, Norman E. Lepor, Jenny Liu, Holly Lofton, Charles F. Lovell, Steven P. Marso, Eric Folkens, B.K. McLean, Peter Meyers, Avinash Murthy, Wallace Johnson, Samer N. Nakhle, Philip J. O’Donnell, Alexander Perkelvald, Athena Philis-Tsimikas, Talessa Powell, Richard E. Pratley, Raman Purighalla, Marina A. Raikhel, Neda Rasouli, Jeffrey Zacher, Joseph A. Risser, Marcelo Correia, Glenn D. Rosen, Aditya K. Samal, William Sargeant, Airani Sathananthan, Robert J. Anderson, Yshay Shlesinger, John Poremba, Elias S. Siraj, Kanagaratnam Sivalingam, Stephen K. Smith, Brian D. Snyder, Ryan Murray, C. W. Sofley, Christopher Still, Joshua B. Oaks, MARK L. WARREN, Kathleen Harris, Craig Wierum, Alan Wynne, Suraj Saggar, Tira Chaicha-Brom, Qingyang Yuan, David Klonoff, Minesh Patel, Narendra Singh, Senan Sultan, Juan C. Garza, Robert P. Morin, Thaddeus H. Riley, Ayham Shneker, Ania M. Jastreboff, James Wallace, J. Christopher Condit, Michael J. Koren, Iqbal Munir, B.V. Weber, Naseem A. Jaffrani, Eric Hewitt, Maja Delibasic, Steven Lupovitch, Ashwini K Davuluri, Sathya S. Krishnasamy, Kathleen Ward, Carlos Sotolongo, Mauricio Concha, Azazuddin Ahmed, Jeffrey Carr, Brian Heimer, Stuart Zarich, Emily Morawski, Ranganatha P. Potu, Richard S. Lorraine, Maher Agha, Mehrdad Ariani, Wa'el Bakdash, Marc Bernstein, Cristian F. Breton, Alexander Dela Llana, Paul Opsahl, Barry Harris, Bruce Iteld, Hiba Abou Assi, Timothy Logemann, Imran A. Siddiqui, Stephen Ong, Elba A. Perez-Vargas, Renee Sangrigoli, Howard S. Wenocur, Louis J. Levy, David D. McPherson, Bradley Block, Sidney C. Gorton, Mansoor Qureshi, Felix Sigal, Devjit Tripathy, Steven K Brodie, Anthony Vo, Howard Weintraub, Jonathan P. Wilson, LOUIS J ARONNE, Hanid Audish, Seth J. Baum, Isaac Sabry Naeem Beshay, William Herzog, Danish Jabbar, Peter Levins, Gary Miller, Richard E. Mills, Patrick Oneil, Rodica Pop-Busui, John Pullman, David C. Robbins, David Robertson, Helena W. Rodbard, Royce Keith Solano, Joseph Soufer, Aparna Tamirisa, Lisa S. Usdan, Joseph A. Lash, Jesse A. Doran, Hayden Bosworth, Ali Iranmanesh, Jennifer Sidey, Frank McGrew, Ciro R. Reyes, Michael Gambill, Ronald D'Agostino, James Welker, Henry Tran, David Kandath, Harold Bays, Robert Buynak, Rodolfo Carrillo-Jimenez, Cuper Martinez, Fahed Bitar, Adline Ghazi, Arti Bhan, John Scott, Harvey Serota, Edward Pereira, Keith Friedman, Dale Crawford Allison, Sandeep Chandra, Aliaksandr Trusau, Neerav Shah, Suhail Khadra, Douglas Spriggs · 发表于：JAMA Cardiology · 年份：2025 · DOI：10.1001/jamacardio.2025.4824 · 被引用次数：5 · 研究领域：Diabetes Treatment and Management、Bariatric Surgery and Outcomes、Cardiovascular Function and Risk Factors

Importance: The primary analysis of the SELECT randomized clinical trial suggests that semaglutide reduced the rates of cardiovascular (CV) death, myocardial infarction, and stroke in patients with established CV disease (CVD) and overweight or obesity without diabetes. However, the effect of semaglutide on hospitalizations in this population remains unknown. Objective: To determine the impact of semaglutide on total hospital admissions and duration of hospital stay. Design, Setting, and Participants: The SELECT trial included patients aged 45 years or older with established CVD and a body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) of 27 or higher without diabetes at 804 clinical settings across North America, South America, Europe, Asia, Africa, and Australia. Patients were randomized from October 2018 to March 2021. This prespecified exploratory analysis was conducted from February 2024 to September 2025. Interventions: Once-weekly subcutaneous semaglutide, 2.4 mg, or placebo. Main Outcomes and Measures: The total number of hospital admissions and days in hospital between the semaglutide and placebo groups. Results: A total of 17 604 patients (median [IQR] age, 61.0 [55.0-68.0] years; 4872 female patients [27.7%]; median [IQR] BMI, 32.1 [29.7-35.7]) were followed up for a median (IQR) period of 41.8 (33.0-47.0) months. There were 11 287 hospital admissions. The number of total hospitalizations was lower in the semaglutide group v...