Michael McHale , 2025-05-13 07:30:00
Separate study finds GLP-1 medicines combined with bariatric surgery may significantly reduce risk of serious cardiovascular events
Semaglutide, the groundbreaking medication found in Ozempic and Wegovy, can rapidly reduce heart attacks in overweight adults, new research has found.
An international study of 17,000 people with known heart disease, overweight or obesity, but not diabetes, found that the medicine significantly lowered the chances of serious cardiovascular complications occurring.
The analysis of research found that semaglutide was associated with a 38 per cent reduced risk of major adverse cardiovascular events (MACE) within the first three months of use compared to placebo.
Within the first six months, semaglutide was associated with a 41 per cent reduced risk of MACE compared to placebo. At both three and six months, most patients had not yet lost much weight and many were not yet on the full target dose of semaglutide 2.4 mg weekly.
The results came from a secondary analysis of the landmark Semaglutide and Cardiovascular Outcomes (SELECT) trial from the same international research team, and are being presented today at the European Congress on Obesity (ECO) in Malaga, Spain.
“These results highlight semaglutide’s early action on decreasing major cardiovascular events, with significant benefits already evident by the first six months, and for some, even earlier, even before any major weight loss, and before most patients would have been titrated to their full target dose of 2.4 mg,” said lead author Dr Jorge Plutzky of Brigham and Women’s Hospital in Boston.
“Our findings reveal an early separation in the treatment effect of semaglutide that occurs even without a significant amount of weight lost and prior to full semaglutide titration,” he added.
“More research is needed to understand the mechanisms through which semaglutide produces these early clinical benefits, but they may include the drug’s positive effects on reducing inflammation, blood sugar, blood pressure, direct effects on the heart and blood vessels, early dietary changes, or an interaction among these or other responses.”
Despite these findings, the authors note that SELECT is not a trial looking to prevent first cardiovascular events—all SELECT patients had a history of heart disease, placing them at high risk.
It is worth noting, they say, given their cardiovascular history, that SELECT patients were already on other cardio-protective medications, for example to tackle cholesterol and blood pressure, meaning semaglutide had benefits on top of these other agents.
Semaglutide is a GLP-1 receptor antagonist (GLP-1RA) initially approved for treating adults with type 2 diabetes, in whom it has already shown cardiovascular benefit. Semaglutide is also approved for weight loss in people with obesity or overweight who have at least one other health issue.
Other research presented at ECO found that treatment with GLP-1RAs – which also include liraglutide (Mounjaro) – after bariatric surgery is associated with a reduction of up to 67 per cent in the risk of serious cardiac events or death.
The results came from a study of 822 adults with obesity and type 2 diabetes who did not achieve sufficient weight loss and diabetes control following surgery.
Participants had no prior history of ischemic heart disease, ischemic stroke, congestive heart failure, or GLP-1RA treatment before surgery.
Each participant treated with a GLP-1RA post-surgery was matched with another patient who underwent bariatric surgery alone, based on sex, age, BMI at the start of the study, and the number of years since surgery.
During an average follow-up of around 1.7 years, 18 patients were diagnosed with a new MACE or died. The analysis found that new cases of MACE or death from any cause occurred in 13 of 411 (3.2 per cent) surgery-only patients, and in five of 411 (1.2 per cent) patients treated with a GLP-1RA post-surgery—with GLP-1RA treatment linked to a 67 per cent reduction in MACE or death.
“These findings provide important initial clinical insights,” said co-lead author Prof Orna Reges from Ariel University in Israel.
“In real-life settings, people living with obesity and type 2 diabetes are at increased risks of cardiovascular disease, and these results suggest that initiating GLP-1RAs after bariatric surgery may help to achieve sustained reductions in weight and blood glucose levels – comparable to those achieved by bariatric surgery alone in other patients – and may also reduce the long-term risk for MACE.”
