The SELECT Trial: How Semaglutide Earned Its Cardiovascular Approval

Part of the DietApp.com GLP-1 Trial Database, a comprehensive, regularly reviewed resource.

What It Is

SELECT is the clinical trial that established semaglutide's approval for reducing cardiovascular risk, separate from its weight-management or diabetes indications. Published by Lincoff and colleagues in the New England Journal of Medicine in 2023, it enrolled 17,604 adults with established cardiovascular disease and overweight or obesity, but without diabetes.

Key Results

Semaglutide 2.4 mg reduced major adverse cardiovascular events, a combined measure of cardiovascular death, heart attack, and stroke, by 20% compared to placebo, over a median follow-up of 39.8 months. This result is significant specifically because it demonstrated a cardiovascular benefit independent of diabetes status, in a population that had cardiovascular disease but not diabetes.

Why This Trial Matters Beyond the Numbers

SELECT is the evidence base behind Wegovy's cardiovascular risk reduction indication, distinct from its original weight-management approval. It's also part of a broader pattern across GLP-1 cardiovascular outcome trials, including earlier diabetes-focused trials like LEADER and SUSTAIN-6, that consistently found cardiovascular benefits across this medication class.

A Perception Gap Worth Knowing

In the same physician survey referenced elsewhere in this library, only 48.4% of physicians correctly perceived a cardiovascular benefit in diabetic patients, statistically no better than random guessing, and only 39.3% correctly perceived it in non-diabetic patients, below random guessing. This suggests SELECT's findings may not yet be as widely internalized among prescribers as the trial data itself supports.

References

• Lincoff AM et al., SELECT Trial, NEJM 2023
• DermaVue: GLP-1 Clinical Evidence Library
• PMC: Physician Perceptions of GLP-1 Safety and Efficacy

Related Resources

• Semaglutide Medication Guide
• Wegovy Medication Guide

Related Articles

• The STEP Trials
• What Is A1C and Why Does It Matter on a GLP-1 Medication?

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DietApp.com combines evidence-based GLP-1 medication education with practical treatment tracking tools. The information on DietApp.com is intended for educational purposes only and should not replace professional medical advice, diagnosis, or treatment.

Last medically reviewed and updated: July 11, 2026.