The Department of Endocrinology, 
Semaglutide and Hospitalizations in Patients With Obesity and Established Cardiovascular Disease: An Exploratory Analysis of the SELECT Randomized Clinical Trial.
- Monash Victorian Heart Institute and Monash University, Melbourne, Victoria, Australia.
- Pennington Biomedical Research Center, Baton Rouge, Louisiana.
- Institute of Cardiovascular Science, University College London, London, United Kingdom.
- Hospital da Luz, Lisbon, Portugal.
- Division of Molecular and Clinical Medicine, University of Dundee, Dundee, United Kingdom.
- Faculty of Medicine, Universiti Kebangsaan Malaysia (National University of Malaysia), Kuala Lumpur, Malaysia.
- Department of Cardiovascular Medicine, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
- Department of Internal Medicine/Endocrinology and Peter O'Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas.
- Novo Nordisk A/S, Søborg, Denmark.
- Universidad Favaloro, Buenos Aires, Argentina.
- Department of Medicine, VA Puget Sound Health Care System and University of Washington, Seattle.
JAMA cardiology Vol. 11 · Issue 2 · pp. 156-164
PMID 41433034 DOI 10.1001/jamacardio.2025.4824
Cite This Article
Stephen J Nicholls, Donna H Ryan, John Deanfield, Daniel Ferreira, Chim C Lang, A Michael Lincoff, Ildiko Lingvay, Christopher Lübker, Paula Pérez Terns, Søren Rasmussen, Signe Stensen, Peter E Weeke, Steven E Kahn. Semaglutide and Hospitalizations in Patients With Obesity and Established Cardiovascular Disease: An Exploratory Analysis of the SELECT Randomized Clinical Trial. JAMA cardiology. 2026;11(2):156-164. doi:10.1001/jamacardio.2025.4824
Abstract
IMPORTANCE: The primary analysis of the SELECT randomized clinical trial suggests that semaglutide reduced the rates of cardiovascular (CV) death, myocardial infarction, and stroke in patients with established CV disease (CVD) and overweight or obesity without diabetes. However, the effect of semaglutide on hospitalizations in this population remains unknown.OBJECTIVE: To determine the impact of semaglutide on total hospital admissions and duration of hospital stay.DESIGN, SETTING, AND PARTICIPANTS: The SELECT trial included patients aged 45 years or older with established CVD and a body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) of 27 or higher without diabetes at 804 clinical settings across North America, South America, Europe, Asia, Africa, and Australia. Patients were randomized from October 2018 to March 2021. This prespecified exploratory analysis was conducted from February 2024 to September 2025.INTERVENTIONS: Once-weekly subcutaneous semaglutide, 2.4 mg, or placebo.MAIN OUTCOMES AND MEASURES: The total number of hospital admissions and days in hospital between the semaglutide and placebo groups.RESULTS: A total of 17 604 patients (median [IQR] age, 61.0 [55.0-68.0] years; 4872 female patients [27.7%]; median [IQR] BMI, 32.1 [29.7-35.7]) were followed up for a median (IQR) period of 41.8 (33.0-47.0) months. There were 11 287 hospital admissions. The number of total hospitalizations was lower in the semaglutide group vs placebo for any indication (18.3 vs 20.4 admissions per 100 patient-years; mean ratio [MR], 0.90; 95% CI, 0.85-0.95; P CONCLUSIONS AND RELEVANCE: In this prespecified exploratory analysis of the SELECT randomized clinical trial, the trial cohort had a high rate of hospital admissions. Treatment with once-weekly semaglutide was associated with significant reductions in hospital admissions and overall time spent in hospital, extending its benefits beyond CV risk reduction.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03574597.
Keywords
- Humans
- Glucagon-Like Peptides
- Female
- Male
- Hospitalization
- Middle Aged
- Cardiovascular Diseases
- Obesity
- Aged
- Length of Stay
- Body Mass Index
