Semaglutide and Hospitalizations in Patients With Obesity and Established Cardiovascular Disease: An Exploratory Analysis of the SELECT Randomized Clinical Trial.

However, the effect of semaglutide on hospitalizations in this population remains unknown.

然而，司美格鲁肽对这一人群住院影响的效果仍然未知。

Background

To determine the impact of semaglutide on total hospital admissions and duration of hospital stay.

确定司美格鲁肽对总住院次数及住院时长的影响。

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.

设计、环境和参与者：SELECT试验包括45岁或以上的患者，这些患者有确立的心血管疾病（CVD）和体质指数（BMI，按公斤体重除以米身高的平方米计算）为27或更高，且没有糖尿病，在北美、南美、欧洲、亚洲、非洲和澳大利亚的804个临床环境中进行。

Patients were randomized from October 2018 to March 2021.

患者从2018年10月到2021年3月被随机分配。

This prespecified exploratory analysis was conducted from February 2024 to September 2025.

此次预先指定的探索性分析是从2024年2月到2025年9月进行的。

Methods

Once-weekly subcutaneous semaglutide, 2.4 mg, or placebo.

每周一次皮下注射司美格鲁肽，2.4毫克，或安慰剂。

main_outcomes_and_measures

The total number of hospital admissions and days in hospital between the semaglutide and placebo groups.

司美格鲁肽组与安慰剂组之间的总住院次数和住院天数。

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.

共有17,604名患者（中位年龄61.0岁，四分位数间距[55.0-68.0]；女性患者4872名[27.7%]；中位体质指数BMI为32.1，四分位数间距[29.7-35.7]）随访中位时间为41.8个月，四分位数间距[33.0-47.0]。

There were 11 287 hospital admissions.

共有11,287次住院记录。

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 < .001) and for serious adverse events (15.2 vs 17.1 admissions per 100 patient-years; MR, 0.89; 95% CI, 0.84-0.94; P < .001).

在任何原因的住院次数上，semaglutide组与安慰剂组相比更低（每100患者年18.3次对比20.4次；平均比率[MR]，0.90；95%置信区间[CI]，0.85-0.95；P < .001），以及严重不良事件的住院次数（每100患者年15.2次对比17.1次；MR，0.89；95% CI，0.84-0.94；P < .001）。

The number of days hospitalized for any indication per 100 patient-years was lower in the semaglutide group vs placebo (157.2 vs 176.2 days; rate ratio [RR], 0.89; 95% CI, 0.82-0.98; P = .01), as well as hospitalizations for serious adverse events (137.6 vs 153.9 days; RR, 0.89; 95% CI, 0.81-0.98; P = .02).

在任何原因的住院天数上，每100患者年semaglutide组与安慰剂组相比更低（157.2天对比176.2天；比率[RR]，0.89；95% CI，0.82-0.98；P = .01），以及严重不良事件的住院天数（137.6天对比153.9天；RR，0.89；95% CI，0.81-0.98；P = .02）。

No heterogeneity was observed for the reduction of hospital admissions with semaglutide in selected subgroups, including BMI, age, and sex.

在选定的亚组中，包括体质指数（BMI）、年龄和性别，使用司美格鲁肽减少住院率未观察到异质性。

conclusions_and_relevance

In this prespecified exploratory analysis of the SELECT randomized clinical trial, the trial cohort had a high rate of hospital admissions.

在这项SELECT随机临床试验的事先指定的探索性分析中，试验队列的住院率很高。

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.

每周一次使用semaglutide治疗与显著减少住院次数和住院总时间相关，其益处超出了心血管风险降低的范围。

trial_registration

ClinicalTrials.gov Identifier: NCT03574597.

ClinicalTrials.gov注册号：NCT03574597。