| Title: |
Semaglutide effects on incidence and reoccurrence of atrial fibrillation in the SELECT trial |
| Authors: |
Plutzky, J; Colhoun, H M; Deanfield, J E; Hovingh, G K; Lingvay, I; Maeng, M; Rasmussen, S; Ryan, D H; Stensen, S; Verma, S; Weeke, P E; Lincoff, A M |
| Source: |
European Heart Journal ; volume 46, issue Supplement_1 ; ISSN 0195-668X 1522-9645 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2025 |
| Description: |
Background Atrial fibrillation (AF) is associated with substantial cardiovascular (CV) complications including stroke and worsening heart failure (HF). Obesity is an established risk factor for initial and recurrent AF, whereas weight loss is reported to reduce recurrent AF after successful interventions. SELECT was a double-blind, placebo-controlled trial in 17,604 patients aged ≥45 years with atherosclerotic CV disease (ASCVD) and overweight or obesity without diabetes randomised to once-weekly semaglutide or placebo. In SELECT, semaglutide-treated patients had a 20% reduced risk of major adverse CV events (MACE: CV death, nonfatal myocardial infarction or nonfatal stroke) and placebo-corrected weight loss of 8.5%. Purpose To analyse AF and clinical outcomes among those with/without a medical history of AF in SELECT. Methods SELECT patients were identified as having a history of AF (defined as medical history of AF [or atrial flutter] or AF at baseline), as determined by medical history form query obtained at enrolment and under the site investigator’s discretion. Time from randomisation to first MACE, HF outcome (CV death or HF hospitalisation/urgent HF visit) or AF event (recorded as an adverse event) were analysed among those with and without a history of AF. Cumulative incidence rates were calculated using the Aalen–Johansen estimator. Results Among SELECT patients, 1614 (9%) had a history of AF at baseline. Those with a history of AF were older (median age 67 vs 61 years) and had higher body weight (mean 98.1 vs 94.0 kg) versus those without AF, respectively. Patients with a history of AF had a higher incidence of first MACE than those without a history of AF, with similar treatment effect of semaglutide versus placebo in both groups (HR 0.76; 95% CI 0.57–1.02 and HR 0.81; 95% CI 0.72–0.91, respectively; p for interaction not significant [NS]; Fig. 1). The risk of first AF event in the entire cohort, independent of AF history, was less in semaglutide versus placebo groups (HR 0.83; 95% CI ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/eurheartj/ehaf784.4243 |
| Availability: |
https://doi.org/10.1093/eurheartj/ehaf784.4243; https://academic.oup.com/eurheartj/article-pdf/46/Supplement_1/ehaf784.4243/65213479/ehaf784.4243.pdf |
| Rights: |
https://academic.oup.com/pages/standard-publication-reuse-rights |
| Accession Number: |
edsbas.FA089E39 |
| Database: |
BASE |