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Clinical Care and Education Oral Abstract Presentations

DC2439 - The effect of semaglutide on mortality and COVID-19-related deaths - a pre-specified analysis from the SELECT trial

Thursday, November 21, 2024
14:00 - 15:15 AT Time
Location: Room 201

    Presenter(s)

  • Marie Philippe Morin, MD. FRCPC. ABOM (she/her/hers)

    Internal medicine and bariatric medicine specialist
    Institut Universitaire De Cardiologie Et De Pneumologie de Québec, Canada
    Heart and lung Institute
    Québec, Quebec, Canada

    Disclosure(s): Bausch Health: Advisory Board (Ongoing), Grant/Research Support (Ongoing), Speaker/Honoraria (Ongoing); Elli Lilly: Advisory Board (Ongoing), Grant/Research Support (Ongoing), Speaker/Honoraria (Ongoing); Novartis: Speaker/Honoraria (Terminated, August 22, 2024); Novo Nordisk: Advisory Board (Ongoing), Grant/Research Support (Ongoing), Speaker/Honoraria (Ongoing); Rythm: Advisory Board (Ongoing), Grant/Research Support (Ongoing), Speaker/Honoraria (Ongoing)

Blinded Abstract: Background and

Aims: In the SELECT trial, in patients with established cardiovascular (CV) disease and BMI ≥27 kg/m2, once weekly (OW) semaglutide 2.4mg reduced risk of the composite endpoint (CV death, myocardial Infarction, and stroke) and the risk of all-cause mortality versus placebo. This analysis investigated semaglutide 2.4mg effect on all-cause mortality, CV and non-CV death, including subcategories of death and death from COVID-19.

Methods: SELECT enrolled 17,604 participants with pre-existing CV disease without diabetes. An independent committee determined the causes of deaths. Deaths with insufficient data were categorized as undetermined and included as CV death. All described endpoints are considered exploratory.

Results: Of 833 deaths (3.3-years follow-up), 58% were CV-related. Semaglutide reduced the risk of all-cause mortality (HR 0.81, 95% CI 0.71–0.93), CV death (0.85, 0.71–1.01), and non-CVD death (0.77, 0.62–0.95) vs placebo (Figure A). The most common causes of CV deaths were sudden cardiac (0.89, 0.68–1.17) and undetermined deaths (0.85, 0.63–1.15); non-CV deaths were due to infections (0.71, 0.51–0.98). Events of COVID-19 were similar, but fewer patients with semaglutide had serious COVID-19-related adverse events (232 vs 277; p=0.04) or died from COVID-19 (0.66, 0.44–0.96) (Figure B).

Conclusion: Semaglutide 2.4mg reduced all-cause mortality. The lower rate of non-CV deaths with semaglutide vs placebo was predominately due to fewer infectious (COVID-19) deaths, supporting the hypothesis of involvement of diverse mechanisms some of which may be unrelated to atherosclerosis.