{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:04:05Z","timestamp":1786122245215,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007051","name":"Uppsala Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007051","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n In the SELECT trial, semaglutide reduced major adverse cardiovascular outcomes (MACE) in individuals with overweight or obesity and established cardiovascular disease (CVD) but without diabetes. However, real\u2010world cardiovascular event rates in comparable populations remain uncharacterised. We therefore aimed to (1) assess real\u2010world cardiovascular outcomes in a SELECT\u2010like cohort with obesity, (2) compare them to the general population and a broader population of individuals with obesity and (3) evaluate the cardiovascular preventive potential of semaglutide in this SELECT\u2010like cohort with obesity.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We used healthcare registries and electronic health records from three Swedish regions (2013\u20132023), covering ~40% of the national population, to identify individuals aged \u2265\u200945\u2009years with obesity (body mass index [BMI] \u2265\u200930\u2009kg\/m\n 2<\/jats:sup>\n ) and established CVD but without diabetes, in alignment with the SELECT trial criteria. Cardiovascular outcomes in this\n SELECT\u2010like obesity cohort<\/jats:italic>\n were compared with matched individuals from the general population as well as with a broader population of individuals with obesity, irrespective of CVD status or other comorbid conditions. To estimate the number needed to treat (NNT), the relative treatment effect of semaglutide observed in the SELECT trial was applied to the absolute risks identified in the\n SELECT\u2010like obesity cohort<\/jats:italic>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The\n SELECT\u2010like obesity cohort<\/jats:italic>\n (\n n<\/jats:italic>\n \u2009=\u20099652) had a mean (SD) age of 68.4 (11.3) years, a mean BMI of 33.1\u2009kg\/m\n 2<\/jats:sup>\n (SD 3.5) and 57.9% were men. Most had a history of myocardial infarction (48.1%) or stroke (41.7%). Over a mean (SD) follow\u2010up of 5.4 (3.2) years, MACE occurred in 21.7%. Compared with the SELECT trial, this real\u2010world population had a higher mean age, had a higher proportion of females, and more often had a prior stroke. Applying the estimated effect of semaglutide from the SELECT trial, the NNT to prevent one MACE was 35 (95% CI, 24\u201366). Compared with the\n General population cohort<\/jats:italic>\n (\n n<\/jats:italic>\n \u2009=\u200948\u2009260), the\n SELECT\u2010like obesity cohort<\/jats:italic>\n had a higher burden of cardiovascular and obesity\u2010related comorbidities and an increased risk of adverse cardiovascular outcomes, including MACE (HR 2.3 [2.2\u20132.4]) and heart failure (HR 2.7 [2.5\u20132.9]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In a real\u2010world setting, despite the use of extensive preventive medications, individuals with obesity and CVD had a higher risk of adverse cardiovascular outcomes and mortality compared with the SELECT trial as well as the general population. These findings highlight the substantial disease burden and the need for improved secondary CVD prevention strategies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.70899","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:16:36Z","timestamp":1781669796000},"page":"8057-8071","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular Outcomes in a\n SELECT<\/scp>\n \u2010Like Obesity Cohort: Real\u2010World Insights From the Swedish\n AROS<\/scp>\n Database"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3385-4777","authenticated-orcid":false,"given":"Viveca","family":"Ritsinger","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine Solna Karolinska Institute Stockholm Sweden"},{"name":"Department of Research and Development Region Kronoberg V\u00e4xj\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefine","family":"Fagerstr\u00f6m","sequence":"additional","affiliation":[{"name":"Novo Nordisk Scandinavia AB Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e5kan","family":"Nero","sequence":"additional","affiliation":[{"name":"Novo Nordisk Scandinavia AB Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Cars","sequence":"additional","affiliation":[{"name":"Sence Research AB Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria K.","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Renal Medicine Uppsala University Uppsala Sweden"},{"name":"Uppsala Clinical Research Centre Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4467-0132","authenticated-orcid":false,"given":"Anna","family":"Norhammar","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Solna Karolinska Institute Stockholm Sweden"},{"name":"Capio S:t G\u00f6rans Hospital Stockholm 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