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)
Authors' conclusion
In 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
Study context
- Population
- Individuals aged ≥45 years with atherosclerotic cardiovascular disease (ASCVD) and overweight/obesity but without DM, US database (01/01/2016–12/31/2023)matched cohort
- Participants
- 9,321 vs 18,642
- Exposure
- Semaglutide 2.4 mg vs no semaglutide
- Semaglutide 2.4 mgn = 9,321
- Not on semaglutiden = 18,642reference
- Outcome
- rMACE-3 (MI, stroke, all-cause mortality) and rMACE-5 (rMACE-3, coronary revascularisation, hospitalisation for HF)
Methodological detailsreal-world, propensity-score matched 1:2, US database, interim analysis
- Real-world
- Propensity-score matched 1:2
- US database
- Interim analysis
Main finding
As reported in the abstract
mean follow-up 200 days
Hazard ratio
0.55
P < 0.001
rMACE-5
Hazard ratio
0.43
P < 0.001
rMACE-3
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR | P value |
|---|---|---|
| MACE-5 and MACE-3 (CV-related mortality replacing all-cause mortality) · mean follow-up 200 daysSemaglutide 2.4 mg vs Not on semaglutide · MACE-5 | 0.65 | P < 0.001 |
| MACE-5 and MACE-3 (CV-related mortality replacing all-cause mortality) · mean follow-up 200 daysSemaglutide 2.4 mg vs Not on semaglutide · MACE-3 | 0.58 | P < 0.01 |
Components and exploratory outcomes
- Semaglutide 2.4 mg associated with lower risks of all-cause mortality, CV-related mortality, hospitalisation for HF, and all exploratory outcomes (incident T2D, major adverse kidney events, major obesity-related adverse events)
Original publication
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). Diabetes Obes Metab. Published 9 September 2025. doi:10.
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