Cardiovascular Outcomes in a SELECT ‐Like Obesity Cohort: Real‐World Insights From the Swedish AROS Database
Authors' conclusion
In a real-world setting, despite the use of extensive preventive medications, individuals with obesity and CVD had a higher risk of adverse cardiovascular outcomes and mortality compared with the SELECT trial as well as the general population.
Study context
- Population
- Individuals aged ≥ 45 years with obesity (BMI ≥ 30 kg/m²) and established cardiovascular disease (CVD) without diabetes, healthcare registries and electronic health records from three Swedish regions (2013–2023); mean age 68.4 years, 57.9% men
- Participants
- 9,652 vs 48,260
- Exposure
- SELECT-like obesity cohort vs matched general population
- SELECT-like obesityn = 9,652
- General populationn = 48,260reference
- Outcome
- Real-world cardiovascular outcomes (MACE) in a SELECT-like cohort with obesity
- Follow-up
- Mean (SD) 5.4 (3.2) years
Methodological detailsregistry-based, matched general population comparison
- Registry-based
- Matched general population comparison
Main finding
As reported in the abstract
MACE in the SELECT-like obesity cohort · mean (SD) follow-up 5.4 (3.2) years
MACE occurred in the SELECT-like obesity cohort
21.7%
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| Adverse CV outcomes vs general population (MACE, HF)SELECT-like obesityvs General populationMACE | 2.3 (2.2–2.4) | |
| Adverse CV outcomes vs general population (MACE, HF)SELECT-like obesityvs General populationHeart failure | 2.7 (2.5–2.9) | |
| 0.20.5125Hazard ratio (log scale) |
NNT with semaglutide to prevent one MACE in the SELECT-like obesity cohort (SELECT trial effect applied)
- NNT to prevent one MACE, applying the SELECT trial semaglutide effect
- 35 (95% CI 24-66)
- Estimated from the SELECT trial relative treatment effect applied to the cohort's absolute risks
Original publication
Cardiovascular Outcomes in a SELECT ‐Like Obesity Cohort: Real‐World Insights From the Swedish AROS Database. Diabetes Obes Metab. Published 16 June 2026. doi:10.
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