- Question
- Can semaglutide reduce cardiovascular events in people with established cardiovascular disease and overweight or obesity but without diabetes?
- Design
- Multicenter, randomized, double-blind, placebo-controlled, event-driven superiority trial with 1:1 allocation. A total of 17604 patients were enrolled, with a mean follow-up of 39.8 months.
- Population
- Patients aged 45 years or older with established cardiovascular disease, a body-mass index of 27 or greater, and no history of diabetes.
- Intervention
- Once-weekly subcutaneous semaglutide at a dose of 2.4 mg, added to standard of care.
- Control
- Once-weekly subcutaneous placebo, added to standard of care.
- Primary outcome
- Composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, analyzed as time to first event.
- Results
- The primary end point occurred in 569 of 8803 patients (6.5%) in the semaglutide group and 701 of 8801 (8.0%) in the placebo group (HR 0.80; 95% CI 0.72 to 0.90; P<0.001).
- Safety
- Adverse events leading to permanent discontinuation of the trial product were more frequent with semaglutide (16.6%) than with placebo (8.2%) (P<0.001).
- Conclusion
- In patients with established cardiovascular disease and overweight or obesity without diabetes, weekly semaglutide was superior to placebo in reducing the composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke.
- Why it matters
- It was the first trial to show a cardiovascular benefit of a weight-directed GLP-1 receptor agonist in people without diabetes, broadening the role of these drugs in secondary prevention for patients with obesity.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 7, 2026