Evidence map›GLP-1 receptor agonists × cardiovascular events›PMID 39217559›Full record

Trial reportJournal of the American College of Cardiology2024

The Effect of Semaglutide on Mortality and COVID-19-Related Deaths: An Analysis From the SELECT Trial.

Benjamin M Scirica, A Michael Lincoff, Ildiko Lingvay, Pawel Bogdanski, Silvio Buscemi, Helen Colhoun, Anca-Elena Craciun, Marat Ezhov, Søren Hardt-Lindberg, Ole Kleist Jeppesen and 9 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
PubMed Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2024. The graph read 7 numbers from its abstract, feeding 3 cells of the map: it supports the treatment in 1, favours the comparator in 1, finds no clear difference in 1. It reports registered trial NCT03574597. Cited by 24 papers.

7numbers the graph read from it
3cells of the map it votes in
24citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
0.51 · no effect
Cardiovascular eventsno clear difference · against placebo · ascvd, obesityfeeds one cell of the map
HR 0.890.68 to 1.17
The most common causes of CV death with semaglutide vs placebo were sudden cardiac death (98 vs 109; HR: 0.89; 95% CI: 0.68-1.17) and undetermined death (77 vs 90; HR: 0.85; 95% CI: 0.63-1.15).
FeedsGLP-1 receptor agonists×cardiovascular events
All-cause mortalityfavours the treatment · against placebo · ascvd, obesityfeeds one cell of the map
HR 0.770.62 to 0.95
Participants assigned to semaglutide vs placebo had lower rates of all-cause death (HR: 0.81; 95% CI: 0.71-0.93), CV death (HR: 0.85; 95% CI: 0.71-1.01), and non-CV death (HR: 0.77; 95% CI: 0.62-0.95).
FeedsGLP-1 receptor agonists×all-cause mortality
Cardiovascular eventsfavours the treatment · against placebo · ascvd, obesityfeeds one cell of the map
HR 0.710.51 to 0.98
Infection was the most common cause of non-CV death and occurred at a lower rate in the semaglutide vs the placebo group (62 vs 87; HR: 0.71; 95% CI: 0.51-0.98).
FeedsGLP-1 receptor agonists×cardiovascular events
Cardiovascular eventsno clear difference · against placebo · ascvd, obesityfeeds one cell of the map
HR 0.850.63 to 1.15
The most common causes of CV death with semaglutide vs placebo were sudden cardiac death (98 vs 109; HR: 0.89; 95% CI: 0.68-1.17) and undetermined death (77 vs 90; HR: 0.85; 95% CI: 0.63-1.15).
FeedsGLP-1 receptor agonists×cardiovascular events
Adverse events & safetyfavours the treatment · against placebo · ascvd, obesityfeeds one cell of the map
HR 0.660.44 to 0.96
Semaglutide did not reduce incident COVID-19; however, among participants who developed COVID-19, fewer participants treated with semaglutide had COVID-19-related serious adverse events (232 vs 277; P = 0.04) or died of COVID-19 (43 vs 65; HR: 0.66; 95% CI: 0.44-0.96).
FeedsGLP-1 receptor agonists×adverse events & safety
All-cause mortalityfavours the treatment · against placebo · ascvd, obesityfeeds one cell of the map
HR 0.810.71 to 0.93
Participants assigned to semaglutide vs placebo had lower rates of all-cause death (HR: 0.81; 95% CI: 0.71-0.93), CV death (HR: 0.85; 95% CI: 0.71-1.01), and non-CV death (HR: 0.77; 95% CI: 0.62-0.95).
FeedsGLP-1 receptor agonists×all-cause mortality
All-cause mortalityno clear difference · against placebo · ascvd, obesityfeeds one cell of the map
HR 0.850.71 to 1.01
Participants assigned to semaglutide vs placebo had lower rates of all-cause death (HR: 0.81; 95% CI: 0.71-0.93), CV death (HR: 0.85; 95% CI: 0.71-1.01), and non-CV death (HR: 0.77; 95% CI: 0.62-0.95).
FeedsGLP-1 receptor agonists×all-cause mortality

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GLP-1 receptor agonists×cardiovascular events

InconclusiveOpen on the map →What to test next →

13 readable studies in this cell: 6 favour the treatment, 3 find no difference, 4 favour the comparator.

Belief with this paper
0.50contested · 7 families support, 3 contradict · against placebo
Without it
0.50This paper does not move the number.
← favours the treatmentfavours the comparator →
1 · no effect
This paper17,604 enrolled · 2018
HR 0.850.63 to 1.15
NCT0399313226,774 enrolled · 2018
HR 1.010.91 to 1.11
NCT013949529,901 enrolled · 2011
HR 0.880.79 to 0.99
NCT039143269,651 enrolled · 2019
HR 0.860.77 to 0.96
NCT011790489,341 enrolled · 2010
HR 0.870.78 to 0.97
NCT038191533,533 enrolled · 2019
HR 0.760.66 to 0.88
NCT017204463,297 enrolled · 2013
HR 0.740.58 to 0.95
NCT026927163,183 enrolled · 2017
HR 0.790.57 to 1.11
Liraglutide in Acute Minor Ischemic Stroke or High-Risk Transient Isch…PMID 41182740 · 1,708 enrolled · 2019
OR 1.951.28 to 3.00
NCT05564039282 enrolled · 2022
OR 20.48.40 to 49.8
Effects of Semaglutide With or Without Concomitant Mineralocorticoid R…PMID 40730031 · 2025
HR 0.510.30 to 0.86

GLP-1 receptor agonists×all-cause mortality

SupportsOpen on the map →What to test next →

11 readable studies in this cell: 6 favour the treatment, 5 find no difference, 0 favour the comparator.

Belief with this paper
0.88replicated · 7 families support, 1 contradict · against placebo
Without it
0.86This paper moves it by +0.02.
← favours the treatmentfavours the comparator →
1 · no effect
This paper17,604 enrolled · 2018
HR 0.850.71 to 1.01
NCT0399313226,774 enrolled · 2018
HR 0.990.83 to 1.18
NCT013949529,901 enrolled · 2011
HR 0.880.79 to 0.99
NCT039143269,651 enrolled · 2019
HR 0.860.77 to 0.96
NCT011790489,341 enrolled · 2010
HR 0.870.78 to 0.97
NCT038191533,533 enrolled · 2019
HR 0.760.66 to 0.88
NCT017204463,297 enrolled · 2013
HR 0.740.58 to 0.95
NCT026927163,183 enrolled · 2017
HR 0.790.57 to 1.11
Effects of Liraglutide on Clinical Stability Among Patients With Advan…PMID 27483064 · 300 enrolled · 2013
HR 1.100.57 to 2.14
[SURPASS CVOT : cardiovascular benefits with tirzepatide versus dulagl…PMID 41815032 · 2026
HR 0.840.75 to 0.94
Risk of adverse events with liraglutide in heart failure with reduced …PMID 36082522 · 2023
IRR 1.410.98 to 2.04

GLP-1 receptor agonists×adverse events & safety

ContradictsOpen on the map →What to test next →

40 readable studies in this cell: 47 favour the treatment, 14 find no difference, 2 favour the comparator.

Belief with this paper
0.02contested · 1 family supports, 41 contradict · against placebo
Without it
0.02This paper does not move the number.
← favours the treatmentfavours the comparator →
1 · no effect
This paper17,604 enrolled · 2018
HR 0.660.44 to 0.96
NCT0399313226,774 enrolled · 2018
HR 1.010.91 to 1.11
NCT013949529,901 enrolled · 2011
HR 0.930.77 to 1.12
NCT039143269,651 enrolled · 2019
HR 0.860.77 to 0.96
NCT011790489,341 enrolled · 2010
HR 0.880.81 to 0.96
NCT026927163,183 enrolled · 2017
HR 0.790.57 to 1.11
Liraglutide in Acute Minor Ischemic Stroke or High-Risk Transient Isch…PMID 41182740 · 1,708 enrolled · 2019
HR 0.560.34 to 0.91
NCT035964501,278 enrolled · 2018
Treatment effect 1.361.03 to 1.79
4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03574597 phase3completed

SELECT - Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity

Ran2018Enrolled17,604Registered outcomes29Posted comparisons1ConditionsObesity, OverweightArmsPlacebo (semaglutide), semaglutide
PMID 33567185PMID 37952131PMID 32916609other papers from this trial
Open the trial in the graph
5 · Its place in the literature

Who cites it

24 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Review
  8. Observational
  9. Review
  10. Are GLP-1s the first longevity drugs?Nature biotechnology · 2025
    Article
  11. Review
  12. Article
  13. Review
  14. Emerging role of GLP-1 agonists in cardio-metabolic therapy - Focus on Semaglutide.American heart journal plus : cardiology research and practice · 2025
    Review
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

19 authors.

Benjamin M SciricaTIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: bscirica@bwh.harvard.edu.
A Michael LincoffDepartment of Cardiovascular Medicine, Cleveland Clinic and Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
Ildiko LingvayDepartment of Internal Medicine/Endocrinology and Peter O'Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Pawel BogdanskiDepartment of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Science, Poznan, Poland.
Silvio BuscemiDepartment of Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza, University of Palermo, Palermo, Italy; Unit of Clinical Nutrition, Obesity and Metabolic Diseases, University Hospital Policlinico "P. Giaccone," Palermo, Italy.
Helen ColhounInstitute of Genetics and Cancer, University of Edinburgh, Edinburgh, Scotland.
Anca-Elena CraciunDepartment of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Cluj, Romania; Department of Diabetes, Nutrition and Metabolic Diseases, Cluj County Hospital, Cluj, Romania.
Marat EzhovNational Cardiology Research Center, Moscow, Russia.
Søren Hardt-LindbergNovo Nordisk A/S, Søborg, Denmark.
Ole Kleist JeppesenNovo Nordisk A/S, Søborg, Denmark.
Ana Laura S A MatosNovo Nordisk A/S, Søborg, Denmark.
Koichi NodeSaga University, Saga, Japan.
Francois SchieleUniversité de Franche-Comté, SINERGIES, Besançon, France.
Hermann ToplakDepartment of Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.
André van BeekDepartment of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Peter E WeekeNovo Nordisk A/S, Søborg, Denmark.
Stephen D WiviottTIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
John DeanfieldInstitute of Cardiovascular Science, University College London, London, United Kingdom.
Donna RyanPennington Biomedical Research Center, Baton Rouge, Louisiana, USA.

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundPatients with overweight and obesity are at increased risk of death from multiple causes, including cardiovascular (CV) death, with few therapies proven to reduce the risk.

objectivesThis study sought to assess the effect of semaglutide 2.4 mg on all-cause death, CV death, and non-CV death, including subcategories of death and death from coronavirus disease-2019 (COVID-19).

methodsThe SELECT (Semaglutide Effects on Cardiovascular Outcomes in Patients With Overweight or Obesity) trial randomized 17,604 participants ≥45 years of age with a body mass index ≥27 kg/m

resultsOf 833 deaths, 485 (58%) were CV deaths, and 348 (42%) were non-CV deaths. Participants assigned to semaglutide vs placebo had lower rates of all-cause death (HR: 0.81; 95% CI: 0.71-0.93), CV death (HR: 0.85; 95% CI: 0.71-1.01), and non-CV death (HR: 0.77; 95% CI: 0.62-0.95). The most common causes of CV death with semaglutide vs placebo were sudden cardiac death (98 vs 109; HR: 0.89; 95% CI: 0.68-1.17) and undetermined death (77 vs 90; HR: 0.85; 95% CI: 0.63-1.15). Infection was the most common cause of non-CV death and occurred at a lower rate in the semaglutide vs the placebo group (62 vs 87; HR: 0.71; 95% CI: 0.51-0.98). Semaglutide did not reduce incident COVID-19; however, among participants who developed COVID-19, fewer participants treated with semaglutide had COVID-19-related serious adverse events (232 vs 277; P = 0.04) or died of COVID-19 (43 vs 65; HR: 0.66; 95% CI: 0.44-0.96). High rates of infectious deaths occurred during the COVID-19 pandemic, with less infectious death in the semaglutide arm, and resulted in fewer participants in the placebo group being at risk for CV death.

conclusionsCompared to placebo, patients treated with semaglutide 2.4 mg had lower rates of all-cause death, driven similarly by CV and non-CV death. The lower rate of non-CV death with semaglutide was predominantly because of fewer infectious deaths. These findings highlight the effect of semaglutide on mortality across a broad population of patients with CV disease and obesity. (Semaglutide Effects on Cardiovascular Outcomes in Patients With Overweight or Obesity [SELECT]; NCT03574597).

Indexed as

Cardiovascular DiseasesCOVID-19Glucagon-Like PeptidesObesityAgedCause of DeathCOVID-19 Drug TreatmentDouble-Blind MethodFemaleHumansHypoglycemic AgentsMaleMiddle AgedOverweightSARS-CoV-2SemaglutideGlucagon-Like PeptidesHypoglycemic AgentsSemaglutideCOVID-19deathGLP1 receptor agonistobesity

Identifiers

PMID39217559

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.