Controlled study
SELECT: primary cardiovascular composite outcome
In SELECT, among people with established cardiovascular disease and no diabetes, the cardiovascular composite occurred in 569 of 8,803 semaglutide participants and 701 of 8,801 placebo participants; HR 0.80 (95% CI 0.72–0.90), with mean follow-up of 39.8 months.
In SELECT, adverse events led to permanent discontinuation in 1,461 participants (16.6%) receiving semaglutide and 718 (8.2%) receiving placebo, according to the original abstract.
- Evidence design
- Randomized comparison
- Population
- Adults >=45 years with established cardiovascular disease, BMI >=27 kg/m2 and no history of diabetes.
- Assessment period
- Mean follow-up of 39.8 months; During the trial; exact window for this result not extracted
- Reported units
- hazard ratio; %
Keep in view
- Participants had established cardiovascular disease; absolute benefit does not automatically transfer to primary prevention.
- 39.8 months is mean follow-up, not a fixed duration for everyone.
See study details — SELECT
Study design and methods
Randomized comparison
Multicenter, randomized, double-blind, placebo-controlled, event-driven superiority trial, phase 3.
Population
Adults >=45 years with established cardiovascular disease, BMI >=27 kg/m2 and no history of diabetes.
- Outcome definition
- Time to first cardiovascular death, nonfatal myocardial infarction or nonfatal stroke
- Randomized participants
- 17604
- Analysis population
- Full analysis set: all randomized participants, analyzed as randomized.
- Follow-up duration
- Mean
- 39.8
- Standard deviation
- 9.4
- Unit
- months
- Treatment exposure duration
- Mean
- 34.2
- Standard deviation
- 13.7
- Unit
- months
Extracted outcomes
| Outcome and group | Reported value | Assessment period | Sample and denominators | Uncertainty |
|---|---|---|---|---|
| First cardiovascular death, nonfatal myocardial infarction or nonfatal stroke Semaglutide Descriptive result; not an effect estimate | 6.5 % reported event percentage Exact numerator: 569 Unit: % | Mean follow-up of 39.8 months | Reported N: 8803 — full analysis population
| Event-proportion CI not verified; the article reports a hazard-ratio CI. |
| First cardiovascular death, nonfatal myocardial infarction or nonfatal stroke Placebo Descriptive result; not an effect estimate | 8 % reported event percentage Exact numerator: 701 Unit: % | Mean follow-up of 39.8 months | Reported N: 8801 — full analysis population
| Event-proportion CI not verified; the article reports a hazard-ratio CI. |
| First cardiovascular death, nonfatal myocardial infarction or nonfatal stroke Semaglutide versus placebo Effect estimate | 0.8 hazard ratio hazard ratio Unit: hazard ratio | Mean follow-up of 39.8 months | Reported N: 17604 — combined full analysis population
| 95% confidence interval: 0.72 to 0.9 Reported p-value: <0.001 (time to first event comparison) |
| Permanent discontinuation due to adverse events Semaglutide Descriptive result; not an effect estimate | 16.6 % reported event percentage Exact numerator: 1461 Unit: % | During the trial; exact window for this result not extracted | Reported N: Not reported or not verified — outcome-specific denominator not verified
| CI and outcome-specific safety denominator not extracted; reported percentage preserved. |
| Permanent discontinuation due to adverse events Placebo Descriptive result; not an effect estimate | 8.2 % reported event percentage Exact numerator: 718 Unit: % | During the trial; exact window for this result not extracted | Reported N: Not reported or not verified — outcome-specific denominator not verified
| CI and outcome-specific safety denominator not extracted; reported percentage preserved. |
First cardiovascular death, nonfatal myocardial infarction or nonfatal stroke — Semaglutide: extraction context
- Outcome role
- Not specified in the consulted scope
- Scale reference
- participants_with_primary_event
- Extraction location
- Original article abstract; registry FAS definition
First cardiovascular death, nonfatal myocardial infarction or nonfatal stroke — Placebo: extraction context
- Outcome role
- Not specified in the consulted scope
- Scale reference
- participants_with_primary_event
- Extraction location
- Original article abstract; registry FAS definition
First cardiovascular death, nonfatal myocardial infarction or nonfatal stroke — Semaglutide versus placebo: extraction context
- Outcome role
- Not specified in the consulted scope
- Scale reference
- time_to_first_event
- Extraction location
- Original article abstract
- The analysis population was verified; a formal five-attribute estimand was not extracted.
- The hazard ratio is not the ratio of rounded crude percentages.
Permanent discontinuation due to adverse events — Semaglutide: extraction context
- Outcome role
- Descriptive safety outcome
- Extraction location
- Original article abstract
Permanent discontinuation due to adverse events — Placebo: extraction context
- Outcome role
- Descriptive safety outcome
- Extraction location
- Original article abstract
What the curated evidence supports
- In SELECT, among people with established cardiovascular disease and no diabetes, the cardiovascular composite occurred in 569 of 8,803 semaglutide participants and 701 of 8,801 placebo participants; HR 0.80 (95% CI 0.72–0.90), with mean follow-up of 39.8 months.
- In SELECT, adverse events led to permanent discontinuation in 1,461 participants (16.6%) receiving semaglutide and 718 (8.2%) receiving placebo, according to the original abstract.
Limitations
- Participants had established cardiovascular disease; absolute benefit does not automatically transfer to primary prevention.
- 39.8 months is mean follow-up, not a fixed duration for everyone.
Verification scope
Verified through 2026-11-04 within the consulted scope.
- Bibliographic metadata checked
- Yes
- Original article abstract consulted
- Yes
- Full-text consultation
- Not consulted
- Official trial registry consulted
- Yes
- Statistical analysis plan consulted
- No
- Verification boundary
- Verification is limited to the specific fields and sources consulted; it is not a full systematic appraisal or GRADE rating.
Source record
Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (2023). The New England journal of medicine.