Ozempic, Wegovy Can Reduce Heart Attack Risk by 28%, What to Know

Semaglutide reduces risk of heart attack, stroke

One study presented over the weekend, and simultaneously published in The New England Journal of Medicine examined the results of the SELECT trial, a multicenter, double-blind, randomized, placebo-controlled trial by Novo Nordisk to investigate cardiovascular outcomes in patients treated with semaglutide versus a placebo.

Research presented this weekend looks at rates of death, non-fatal heart attack, and non-fatal stroke in patients without diabetes. The drug has already been shown to reduce such events in patients with type 2 diabetes.

The trial is the largest ever conducted by the Danish pharmaceutical company, and included more than 17,000 participants across 41 countries.

The study was conducted between October 2018 and March 2021, and took five years to conduct, including follow-up time with patients.

During the trial, half of the participants were assigned to receive semaglutide (a 2.4mg dose once per week), while the other half received a placebo. Patients in the trial were 45 years of age or older, had a BMI of 27 or greater, and had some form preexisting cardiovascular disease. They had to have no history of diabetes.

Patients who took semaglutide had their risk of serious cardiovascular outcomes reduced across the board: overall risk of a cardiovascular event fell by 20%, heart attack risk dropped by 28%, and stroke by 7%.

There were additional benefits as well. The semaglutide group lost 9.39% of their body weight, compared to less than 1% for the placebo group. They also saw improvements to their blood pressure, cholesterol, and A1C.

Novo Nordisk previously released topline data on their results from the SELECT trial back in August.

New era to treat obesity and heart disease

“I think everyone’s excited and we’ve all been waiting, especially for the SELECT trial, and I think it’s all good news,” Dr. Sun Kim, an Associate Professor of Medicine in Endocrinology at Stanford University, told Healthline. She wasn’t involved in the research.

“Endocrinologists have a particular affinity for this class of drugs because they were first approved in the treatment of type 2 diabetes and managing glucose, but they have been found to have many additional benefits,” she said.

The authors of an accompanying editorial in NEJM wrote, “We are in a new era of treating obesity and cardiometabolic risk with a growing armamentarium of options. The SELECT trial provides evidence of improved cardiovascular disease outcomes with GLP-1 receptor agonists in the absence of diabetes.”

However, they also noted that cost and accessibility of semaglutide are still significant barriers for many individuals.

Novo Nordisk has filed for a label update for Wegovy to include an indication for reducing major adverse cardiovascular events. The FDA has granted the update a priority review for that supplemental New Drug Application.

The company provided Healthline with the following statement from Dr. Michelle Skinner, PharmD, CardioRenal Therapy Area Head, Medical Affairs at Novo Nordisk:

“The full SELECT results presented at AHA mark a turning point in obesity science. We look forward to working with regulatory authorities on the next steps to bring this option to people living with excess weight or obesity and the healthcare providers partnering on their care.”

How semaglutide can help reduce heart failure risk

This weekend, research published in Circulation, the flagship publication of the American Heart Association, investigated semaglutide therapy to improve symptoms of heart failure with preserved ejection fraction, the most common form of heart failure.

Researchers looked at a variety of metrics across areas such as quality of life, social limitations, and physical limitations by using the Kansas City Cardiomyopathy Questionnaire (KCCQ), which gives a score for heart failure symptoms based on a range of factors.

The 52-week randomized, double-blind, placebo-controlled trial included 529 participants. Half of the participants received a 2.4mg weekly injection of semaglutide, while the other half received a placebo. Patients had to have obesity as well as a documented history of HFpEF.

Those treated with semaglutide saw significant improvement of heart failure symptoms indicated by improvements in KCCQ score, greater reduction in body weight, and improvements to physical limitations and exercise function.

“We’re now at the precipice of this avalanche of data that really point us in the direction saying obesity is what’s causing these complications. In order for us to effectively manage these complications, we have to address obesity, we have to target obesity,” Dr. Mikhail Kosiborod, a cardiologist, vice president of research at Saint Luke’s Health System, and lead author of the study, told Healthline.

The results build on previous findings that were published earlier this year.

HFpEF refers to one variety of heart failure in which the heart is too stiff to fill properly.

While heart failure and obesity are separate health issues, they frequently occur together. A review in JAMA earlier this year found that people with overweight and obese BMI had a much higher risk of HFpEF.

Dr. Lynne Warner Stevenson, Professor of Cardiovascular Medicine at Vanderbilt and the director of their Cardiomyopathy Program, who wasn’t affiliated with the research, told Healthline, “This is the exciting peak of this wave that’s been building in terms of trying to find a way to decrease the morbidity and mortality of what I consider to be a Venn diagram of disease, which is obesity, diabetes, and heart failure with preserved ejection fraction.”

The bottom line

New evidence suggests that semaglutide could have far-reaching beneficial effects for cardiovascular health and heart failure.

According to data from Novo Nordisk’s SELECT Trial, patients treated with semaglutide had a 20% reduced overall risk of serious adverse cardiovascular events compared to placebo.

A separate trial also showed that the drug was effective at treating symptoms of heart failure with preserved ejection fraction.