Key result
SELECT-eligible post-MI patients face a ~10% risk of 5-year MACE despite lacking diabetes.
Why the study?
Cardiovascular risk and the preventive potential of semaglutide in first-time MI patients with overweight or obesity and no diabetes meeting SELECT eligibility criteria were not well characterized.
What is the 5-year cardiovascular risk in first-time MI patients with overweight or obesity and no diabetes who meet SELECT eligibility criteria?
Cohort (n=21,777)
What is the 5-year cardiovascular risk in first-time MI patients with overweight or obesity and no diabetes who meet SELECT eligibility criteria?
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“As patient clinical characteristics are heavy determinants of the observed absolute risk, external validity may be threatened. Absolute risk estimates from our contemporary cohort may be generalizable to other countries with comparable low cardiovascular disease risk status.”
“In my opinion, this is kind of a statin treatment when the price becomes more affordable for society, but at the moment we will choose who we can afford to pay for.”
“everyone is grappling with the implementation side of addition to our therapeutic armamentarium. We now have a therapy that can reduce cardiovascular events among obese patients with a prior history of cardiovascular disease. This article begins to bring that sort of population health analysis to life—demonstrating the potential impact in Denmark.”
SELECT-eligible first-time MI patients with overweight or obesity and no diabetes have a substantial 5-year cardiovascular risk, suggesting significant preventive potential for semaglutide in this population.
BACKGROUND: In the SELECT (Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity) trial, treatment with semaglutide reduced the risk of major adverse cardiovascular events (MACE) in patients with cardiovascular disease, overweight or obesity, and no diabetes. OBJECTIVES: The purpose of this study was to estimate cardiovascular risk in first-time myocardial infarction (MI) patients meeting the SELECT-eligibility criteria and the preventive potential for treatment with semaglutide. METHODS: We conducted an observational cohort study applying the SELECT trial's inclusion and exclusion criteria to patients with first-time MI recorded between 2010 and 2021 in the Western Denmark Heart Registry. Five-year incidence of second MI, MACE, and all-cause death was estimated for SELECT-eligible patients with a body mass index (BMI) ≥27 kg/m RESULTS: In 21,777 first-time MI patients without diabetes, 10,768 patients were SELECT-eligible with BMI ≥27 kg/m CONCLUSIONS: In SELECT-eligible first-time MI patients with overweight or obesity and no diabetes, the cardiovascular risk was substantial with 1 in 10 having a MACE event within 5 years after first-time MI. Based on the SELECT trial results, semaglutide may markedly postpone MACE incidence in these patients.
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Hansen et al. (2026) conducted a cohort in First-time myocardial infarction with overweight or obesity and no diabetes (n=21,777). SELECT-eligibility (first-time MI, BMI ≥27 kg/m², no diabetes) was evaluated on MACE within 5 years. SELECT-eligible first-time MI patients with overweight or obesity and no diabetes demonstrated substantial cardiovascular risk, with 10% experiencing a MACE event within 5 years.
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