Eligibility for and practical implications of Semaglutide in overweight and obese patients with acute coronary syndrome
Vincenzo De Sio, Felice Gragnano, Antonio Capolongo, Natale Guarnaccia, Pasquale Maddaluna, Vincenzo Acerbo, Mattía Galli, Martina Berteotti, Simona Sperlongano, Arturo Cesaro, Elisabetta Moscarella, Francesco Pelliccia, Giuseppe Patti, Emilia Antonucci, Plinio Cirillo, Pasquale Pignatelli, Gualtiero Palareti, Vittorio Pengo, Paolo Gresele, Rossella Marcucci, Paolo Calabrò
Abstract
AIMS: Semaglutide has been shown to reduce cardiovascular events in non-diabetic patients with preexisting cardiovascular disease and overweight/obesity in the SELECT trial. Data on the applicability of these results to clinical practice are limited. We evaluated the eligibility for and practical implications of semaglutide in overweight/obese non-diabetic patients with recent acute coronary syndrome (ACS) from a contemporary real-world registry. METHODS: ; history of myocardial infarction (MI), stroke, or peripheral artery disease; no diabetes. Major adverse cardiovascular events (MACE), defined as a composite of all-cause death, MI, target vessel revascularization, or stroke, and net adverse clinical events (NACE), a composite of all-cause death, MI, stroke, or major bleeding, were assessed at 1-year follow-up. RESULTS: The study population comprised 2940 consecutive ACS patients. At 60 days after discharge, 807 patients (27.4 %) met the SELECT eligibility criteria (SELECT-like group) and 2133 patients were ineligible (not-eligible group). At 1 year, incidence of MACE (4.6 % vs. 8.2 %; p = 0.004) and NACE (3.6 % vs. 7.6 %; p < 0.001) was lower in the SELECT-like group compared to the not-eligible group. CONCLUSIONS: In a contemporary real-world registry, a significant proportion of post-ACS patients were eligible for semaglutide according to the SELECT trial criteria. Future studies are needed to evaluate the potential implications of semaglutide for secondary prevention.