Observational studyDiabetes, obesity & metabolism2025

Lower risk of cardiovascular events in patients initiated on semaglutide 2.4 mg in the real-world: Results from the SCORE study (Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity in the Real World).

Kim G Smolderen, Carlos Mena-Hurtado, Zhenxiang Zhao, Wojciech Michalak, Mads Faurby, B Gabriel Smolarz, Mikhail N Kosiborod, Jinlin Song, Yan Chen, Joanna Boland and 1 more

Registry-linked trialAbstract readObservational Study
In one paragraph

Observational study in Diabetes, obesity & metabolism, 2025. The graph read 1 number from its abstract, feeding 1 cell of the map, but none could be read as for or against, so it casts no vote. It is linked to trial NCT06874751 (Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity in the Real World), which is not on this map. Cited by 8 papers.

1number the graph read from it
0cells of the map it votes in
8citing 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.

Read, but not usablea number the graph found but could not read as for or against

RMACE-5semaglutide 2.4 mg vs not on semaglutidecomparator not stated · ascvd, t2dfeeds one cell of the map
HR 0.55p < 0.001
Over a mean follow-up of 200 days, semaglutide 2.4 mg was associated with significantly lower risks of rMACE-5 (hazard ratio: 0.55; p < 0.001), rMACE-3 (0.43; p < 0.001), MACE-5 (0.65; p < 0.001), and MACE-3 (0.58; p < 0.01).

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

No readable resultOpen on the map →What to test next →

13 readable studies in this cell: 7 favour the treatment, 2 find no difference, 4 favour the comparator.

Belief with this paper
0.50contested · 7 families support, 3 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT0399313226,774 enrolled · 2018
HR 1.010.91 to 1.11
NCT0357459717,604 enrolled · 2018
HR 0.800.72 to 0.89
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
OR 1.951.28 to 3.00
NCT05564039282 enrolled · 2022
OR 20.48.40 to 49.8

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

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.

NCT06874751 completednot on this map

Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity in the Real World

TypeobservationalSponsorNovo Nordisk A/SRan2024 to 2025Enrolled45,456ConditionsOverweight, Obesity, Atherosclerotic Cardiovascular Disease (ASCVD)ArmsNo treatment given
5 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Article
  6. Observational
  7. Review
  8. Observational
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

11 authors.

Kim G SmolderenSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Carlos Mena-HurtadoSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Zhenxiang ZhaoNovo Nordisk, Inc, Plainsboro Township, New Jersey, USA.
Wojciech MichalakNovo Nordisk, Inc, Plainsboro Township, New Jersey, USA.
Mads FaurbyNovo Nordisk, Inc, Plainsboro Township, New Jersey, USA.
B Gabriel SmolarzNovo Nordisk, Inc, Plainsboro Township, New Jersey, USA.ORCID https://orcid.org/0000-0002-8591-3858
Mikhail N KosiborodUniversity of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
Jinlin SongAnalysis Group, Inc, Los Angeles, California, USA.
Yan ChenAnalysis Group, Inc, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-5317-1909
Joanna BolandAnalysis Group, Inc, Los Angeles, California, USA.
Michael G NannaSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.ORCID https://orcid.org/0000-0001-5745-1636

Funding

TREATMENT GOALS FOR PERSONS WITH MULTIFACTORIAL GERIATRIC HEALTH CONDITIONSP30AG021342 · YALE UNIVERSITY · 2002 to 2025
$8.0M
Estimating the treatment effect of cardiovascular medications to modify the risk for future cognitive decline in older adultsK76AG088428 · YALE UNIVERSITY · 2025 to 2025
$243k
NIA NIH HHS K76 AG088428NIA NIH HHS P30 AG021342Novo Nordisk, Inc.
8 · The paper itself

Abstract

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

aimsIn this first interim analysis of the SCORE study, we investigated the risk of major adverse cardiovascular events (MACE) among individuals with atherosclerotic cardiovascular disease (ASCVD) and overweight/obesity but without diabetes who initiated semaglutide 2.4 mg in real-world settings. MATERIALS AND

methodsIndividuals initiating semaglutide 2.4 mg aged ≥45 years with ASCVD and overweight/obesity but without diabetes were identified in a US database (01/01/2016-12/31/2023) and matched 1:2 to those not on semaglutide based on a non-parsimonious propensity-score model. The primary outcomes included revised 3-point MACE (rMACE-3: myocardial infarction, stroke, and all-cause mortality) and revised 5-point MACE (rMACE-5: rMACE-3, coronary revascularisation, and hospitalisation for heart failure). Secondary outcomes included MACE-3 and MACE-5, defined similarly to rMACE-3 and rMACE-5 but replacing all-cause mortality with cardiovascular-related mortality. Exploratory outcomes included incident type 2 diabetes, major adverse kidney events, and major obesity-related adverse events.

resultsA total of 9321 individuals on semaglutide 2.4 mg were matched to 18,642 individuals not on semaglutide; patient characteristics were well-balanced between cohorts. Over a mean follow-up of 200 days, semaglutide 2.4 mg was associated with significantly lower risks of rMACE-5 (hazard ratio: 0.55; p < 0.001), rMACE-3 (0.43; p < 0.001), MACE-5 (0.65; p < 0.001), and MACE-3 (0.58; p < 0.01). Semaglutide 2.4 mg was also associated with lower risks of all-cause mortality, cardiovascular-related mortality, hospitalisation for heart failure, and all exploratory outcomes.

conclusionsIn this real-world study of US individuals with ASCVD and overweight/obesity but without diabetes, semaglutide 2.4 mg was associated with significantly reduced risk of MACEs and other obesity-related morbidities (NCT06874751).

Indexed as

Cardiovascular DiseasesGlucagon-Like PeptidesHypoglycemic AgentsObesityOverweightAgedAtherosclerosisDiabetes Mellitus, Type 2FemaleGlucagon-Like Peptide 1HumansMaleMiddle AgedSemaglutideGlucagon-Like Peptide 1Glucagon-Like PeptidesHypoglycemic AgentsSemaglutidecardiovascular diseasecohort studyGLP‐1observational studyreal‐world evidencesemaglutide

Identifiers

PMID40926360
PMCPMC12515752

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC
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.