The headline trial: SELECT
SELECT (Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity)
Lincoff et al., New England Journal of Medicine, November 2023
Semaglutide 2.4 mg reduced major adverse cardiovascular events (cardiovascular death, non-fatal heart attack or non-fatal stroke) by 20 percent (hazard ratio 0.80, 95% CI 0.72 to 0.90) over a median 39.8 months in adults with established cardiovascular disease and BMI 27 or higher, none of whom had diabetes. The earlier SUSTAIN-6 trial showed a 26 percent reduction (hazard ratio 0.74) in patients with type 2 diabetes. On the strength of SELECT, Wegovy received an FDA-labeled cardiovascular indication in March 2024.
Trial enrollment criteria
- Established cardiovascular disease: prior heart attack, prior stroke, or symptomatic peripheral artery disease
- BMI 27 or higher (overweight or obesity)
- No type 2 diabetes (SELECT specifically enrolled patients without diabetes)
Does this trial apply to you?
If you have established cardiovascular disease (a prior heart attack, stroke or peripheral artery disease) plus a BMI of 27 or higher, Wegovy is FDA-labeled to lower your risk of another cardiovascular event, and you do not need a diabetes diagnosis to qualify. This is a Medicare Part D-eligible pathway, unlike weight loss alone, which federal law excludes. If you also have type 2 diabetes, Ozempic is the ADA-preferred option for cardiovascular risk reduction.
What to ask your prescriber
- Whether your cardiovascular history is documented with ICD-10 codes (I25.x, I63.x and similar)
- Most recent lipid panel, blood pressure and any recent cardiac imaging
- Whether the cardiovascular indication (Wegovy, SELECT) or the diabetes indication (Ozempic) is the cleaner PA path
- How your cardiologist and prescribing clinician will coordinate dose changes
Editorial notes
- Statins and antiplatelet drugs continue alongside a GLP-1; the cardiovascular benefit adds to standard care rather than replacing it.
- Blood pressure often drops in the first weeks on a GLP-1, so coordinate any dose changes with your cardiologist.
- If you also have type 2 diabetes, kidney disease or heart failure, the stacked condition pages below carry the additional trial evidence.
Clinical trials for Cardiovascular disease
Or browse the full GLP-1 clinical trials directory, filterable by condition, state and phase.
Take it to your prescriber: PA letter templates
Editable prior-authorization letter templates that cite the registration trial above. Pick the plan your prescriber will submit to, copy the template, fill in the patient-specific findings and have your clinician sign and submit.
Not seeing your plan? The full PA letter librarycovers 20 plans × 10 indications = 200 templates. The appeal letter library handles denials.
Drug profiles
Other GLP-1 conditions
Editorial provenance
Editorial review by John, Editor on 2026-05-23, against SELECT (Lincoff et al., New England Journal of Medicine, November 2023). We do not yet have a credentialed medical reviewer on staff (actively recruiting). This page summarises public registration-trial data and FDA labeling. It is not clinician-authored medical advice.
Disclaimer
Educational summary of published registration trial data. Not medical advice. Not a substitute for evaluation by a treating clinician. Trial-level results do not guarantee individual outcomes. Discuss eligibility, contraindications, dose adjustments and drug interactions with your prescriber. We do not have a credentialed medical reviewer on staff yet (actively recruiting); the content below is editor-written from public registration-trial publications and FDA labeling, not clinician-authored medical advice.