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Abstract
The SELECT trial showed a 20% reduction in major adverse cardiovascular events with semaglutide compared to placebo in participants with cardiovascular disease and obesity.
- Weight loss may account for approximately one-third of the cardiovascular benefit observed with semaglutide.
- Additional mechanisms beyond weight loss could significantly contribute to the reduction in cardiovascular events.
- There is a temporal dissociation between weight loss and the early reduction in major adverse cardiovascular events, suggesting direct vascular protective effects of GLP-1 receptor agonists.
- Thromboinflammation, including factors like the neutrophil-NET axis and platelet function, may play a role in the cardiovascular benefits of GLP-1 receptor agonists.
- The specific contribution of thromboinflammation to the cardiovascular benefits remains uncertain, as other pathways such as metabolic and vascular mechanisms may also be involved.
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