Can treatment reduce hospitalization burden in patients with established cardiovascular disease (CVD) and overweight or obesity without diabetes? In the Journal of the American Medical Association Cardiology, a prespecified exploratory analysis of the SELECT randomized clinical trial evaluated the effect of semaglutide on hospital admissions and hospital stay duration.

The trial enrolled patients aged 45 years or older with established CVD and a body mass index (BMI) of 27 or higher without diabetes across 804 clinical settings worldwide. A total of 17,604 patients were included. Median age was 61.0 years (interquartile range [IQR], 55.0-68.0 years), and 4,872 patients (27.7%) were female. Median BMI was 32.1 (IQR, 29.7-35.7). Participants were randomized between October 2018 and March 2021 and followed for a median of 41.8 months (IQR, 33.0-47.0).

During follow-up, 11,287 hospital admissions occurred. Total hospitalizations for any indication were lower with semaglutide compared with placebo (18.3 vs 20.4 admissions per 100 patient-years; mean ratio [MR], 0.90; 95% confidence interval [CI], 0.85-0.95; P < .001). Hospitalizations for serious adverse events were also reduced (15.2 vs 17.1 admissions per 100 patient-years; MR, 0.89; 95% CI, 0.84–0.94; P < .001). Days hospitalized per 100 patient-years were lower with semaglutide for any indication (157.2 vs 176.2 days; rate ratio [RR], 0.89; 95% CI, 0.82-0.98; P = .01) and for serious adverse events (137.6 vs 153.9 days; RR, 0.89; 95% CI, 0.81-0.98; P = .02). No heterogeneity was observed across subgroups defined by BMI, age, or sex.

In this exploratory analysis, semaglutide treatment was associated with fewer hospital admissions and reduced time spent in hospital in patients with established CVD and overweight or obesity without diabetes.