Semaglutide in patients with established cardiovascular disease who are overweight or obese without diabetes was associated with a reduced rate of hospital admissions and shorter length of stay, according to an exploratory analysis of the SELECT trial recently published in JAMA Cardiology.

Stephen J. Nicholls, MBBS, PhD, FACC, et al., included 17,604 patients (median age 61; 28% female; median BMI 32) from 804 centers across the globe randomized to either 2.4 mg of subcutaneous semaglutide weekly or placebo. The study period was from October 2018 through March 2021, and the primary outcome was hospital admissions and days in hospital.

The total number of hospitalizations for any indication over a median follow-up period of 42 months was lower in the treatment group vs. placebo group (18.3 vs. 20.4 per 100 patient-years; mean ratio [MR], 0.90; 95% CI, 0.85-0.95; p<0.001). Number of days hospitalized was also lower in the treatment group (157.2 vs. 176.2 days; rate ratio [RR], 0.89; 95% CI, 0.82-0.98; p=0.01).

Similar trends were noted for number of hospitalizations and days hospitalized specifically for adverse events: 15.2 vs. 17.1 admissions per 100 patient-years (MR, 0.89; 95% CI, 0.84-0.94; p<0.001) and 137.6 vs. 153.9 days (RR, 0.89; 95% CI, 0.81-0.98; p=0.02), respectively.

"Reductions in hospitalization for a range of indications, including cardiac, infection, and respiratory causes, in addition to a decrease in admission for surgical and medical procedures, were observed in the semaglutide group," write the authors. "These findings extend the previously reported benefits of semaglutide on [major adverse cardiovascular events] to a broader range of clinical and health care system outcomes."

Other articles recently published in JAMA Network Open explore the impact of bariatric surgery vs. GLP1-RAs on fat loss and the relationship between GLP1-RA use and asthma risk in adolescents with obesity, respectively.

The first article, authored by Zicheng Wang, MS, et al., found that both bariatric surgery and GLP1-RAs were effective treatments, leading to substantial reductions in fat mass and fat-free mass as well as improved fat mass ratios over 24 months. Greater relative reductions in fat mass and fat-free mass were observed among patients who underwent bariatric surgery.

Another research letter by Yung-Chieh Huang, MD, et al., reports an association between GLP1-RAs and reduced risk of asthma exacerbations among adolescents aged 12 to 18 years with asthma and who are overweight or obese. "Our findings suggest a dual benefit for this population, where a single class of medication could address both weight management and lower risk for asthma exacerbation," write the authors.

For more resources on obesity and heart health, access ACC's Concise Clinical Guidance report on medical weight management to optimize cardiovascular health. Plus, explore JACC's special topic collection on obesity, featuring the latest articles, clinical trials and video interviews with the experts.