SPC365

Prevalence of eligibility criteria for semaglutide according to the SELECT trial in a Portuguese cohort of acute coronary syndrome

Session: Sessão de Posters 48 - Exercício, Estilos de Vida e Obesidade
Speaker: Vanessa Lopes

Congress: CPC 2024
Topic: J. Preventive Cardiology
Theme: 28. Risk Factors and Prevention
Subtheme: 28.14 Risk Factors and Prevention - Other
Session Type: Cartazes
FP Number: ---
Authors: Vanessa Lopes; Rafaela Fernandes; Gil Cunha; Lino Gonçalves
<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">On behalf: Portuguese National Registry of Acute Coronary Syndromes</span></span></span></p>

<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Introduction</span></strong></span></span></p>

<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">The SELECT trial evaluated the efficacy of semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, when added to standard of care, for preventing major adverse cardiovascular events (MACE) in overweight or obese patients with established cardiovascular disease, including myocardial infarction, but without diabetes. More than three-quarters of the patients included in the trial had a previous myocardial infarction. Semaglutide in secondary prevention reduced MACE by 20% compared to placebo<strong>. </strong></span></span></span></p>

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<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Purpose</span></strong></span></span></p>

<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">To determine the prevalence of eligibility criteria for semaglutide in a Portuguese cohort of acute coronary syndrome, based on the SELECT trial inclusion and exclusion criteria.</span></span></span></p>

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<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Methods</span></strong></span></span></p>

<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">Cross-sectional study including&nbsp;patients with acute myocardial infarction (AMI) enrolled in a nationwide registry of acute coronary syndrome between 2010 and 2023, who were alive at the time of hospital discharge. The presence of SELECT key inclusion [&ge;45 years old, body mass index (BMI) &ge;27kg/m<sup>2</sup>] and exclusion criteria (history of diabetes, HbA1c &ge;6.5%, end-stage renal disease or dialysis) were analyzed.</span></span></span></p>

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<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Results</span></strong></span></span></p>

<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">A total of 28512 AMI patients were included in the analysis: mean age was 65.5 &plusmn;13.1 years, 73.1% of patients were male, and half were diagnosed with STEMI (STEMI 49.2% vs. NSTEMI 50.8%).</span></span></span></p>

<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">Among AMI patients, most were older than 45 years (26819, 94.1%), half were overweight or obese (BMI &ge;27 kg/m<sup>2</sup>&nbsp;- 12056, 49.8%; BMI &ge;30 kg/m<sup>2 </sup>- 5731, 23.7%), and a third had diabetes (8390, 30.3%). Patients with NSTEMI were more likely to be older than 45 years (STEMI 92.6% vs. NSTEMI 95.5%, p &lt;0.001), overweight or obese (STEMI 47.6% vs. NSTEMI 52.0%, p &lt;0.001), and diabetic (STEMI 24.4% vs NSTEMI 26.1%, p &lt;0.001). Main results are presented in Table 1. </span></span></span></p>

<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">Of the patients included in the <span style="color:black">analysis, 11255 (39.5%; STEMI 37.9% vs. NSTEMI 41.0%, p &lt;0.001) met the SELECT inclusion crit</span>eria and, after applying exclusion <span style="color:black">criteria, 6834 (24.3%; STEMI 25.5% vs. NSTEMI 23.2%, p &lt;0.001) were eligible for therapy with </span>semaglutide.&nbsp; <span style="color:black">Additionally, despite not being included in the SELECT trial, patients with diabetes are also eligible for the prevention of MACE.</span></span></span></span></p>

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<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:11.0pt">Conclusions:</span></strong></span></span></p>

<p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:11.0pt">Obesity is a prevalent risk factor in a Portuguese population of myocardial infarction patients, with half of the patients <span style="color:black">presenting a BMI of &ge;27 kg/m<sup>2</sup> . In this large nationwide cohort, excluding the diabetic population, 24% of patients </span>were eligible for therapy with semaglutide for secondary prevention of MACE according to the SELECT criteria. </span></span></span></p>