# SELECT: semaglutide and cardiovascular outcomes in overweight or obesity

Study · id `cardio:select-trial` · Cardiovascular Atlas · release `f6f6f1b6f50379ed` (public)

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Also called: SELECT; Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity

Browse, organ or system: Heart; Metabolism  
Browse, condition area: Coronary and vascular disease; Diabetes and metabolic disease  

## In plain language

A large trial of adults aged 45 and over who already had heart or blood-vessel disease and were overweight or obese but did not have diabetes. Half took semaglutide 2.4 mg once a week and half took placebo. The semaglutide group had fewer combined events (heart attack, stroke or heart-related death). More people in the semaglutide group also stopped the medicine because of side effects.

## Technical summary

Double-blind, randomized, placebo-controlled, event-driven superiority trial sponsored by Novo Nordisk (NCT03574597). 17604 patients were enrolled, 8803 assigned to semaglutide 2.4 mg once weekly and 8801 to placebo. The primary outcome was the first of death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke: hazard ratio 0.80 (95% CI 0.72 to 0.90) over a mean follow-up of 39.8 months. Adverse events that led to permanent discontinuation were 16.6% on semaglutide and 8.2% on placebo.

## Key facts

- Design: Multicenter, double-blind, randomized (1:1), placebo-controlled, event-driven superiority trial with parallel groups. The registry records phase 3 and quadruple masking.
- Phase: Phase 3
- Enrolled: 17604 participants (enrolled count; Semaglutide Effects on Heart Disease and Stroke in Patients With Overweight or Obesity, snapshot `cardio:ctgov-nct03574597-2026-10-14`, retrieved 2026-10-14)
- Started: 2018-10-24 (actual) (Semaglutide Effects on Heart Disease and Stroke in Patients With Overweight or Obesity, snapshot `cardio:ctgov-nct03574597-2026-10-14`, retrieved 2026-10-14)
- Primary completion: 2023-06-21 (actual) (Semaglutide Effects on Heart Disease and Stroke in Patients With Overweight or Obesity, snapshot `cardio:ctgov-nct03574597-2026-10-14`, retrieved 2026-10-14)
- Completion: 2023-06-29 (actual) (Semaglutide Effects on Heart Disease and Stroke in Patients With Overweight or Obesity, snapshot `cardio:ctgov-nct03574597-2026-10-14`, retrieved 2026-10-14)
- Results first posted: 2024-08-30 (actual) (Semaglutide Effects on Heart Disease and Stroke in Patients With Overweight or Obesity, snapshot `cardio:ctgov-nct03574597-2026-10-14`, retrieved 2026-10-14)
- Countries: United States; Algeria; Argentina; Australia; Austria; Belgium; Brazil; Bulgaria; Canada; Colombia; Croatia; Czechia; Denmark; Finland; France; Germany; Greece; Hungary; India; Ireland; Israel; Italy; Japan; Latvia; Malaysia; Mexico; Netherlands; Norway; Poland; Portugal; Puerto Rico; Romania; Russia; Serbia; South Africa; Spain; Sweden; Taiwan; Thailand; Ukraine; United Kingdom; Türkiye (Semaglutide Effects on Heart Disease and Stroke in Patients With Overweight or Obesity, snapshot `cardio:ctgov-nct03574597-2026-10-14`, retrieved 2026-10-14)
- Care setting: Not reported
- Registry status: "COMPLETED" (U.S. National Library of Medicine (ClinicalTrials.gov), snapshot `cardio:ctgov-nct03574597-2026-10-14`, retrieved 2026-10-14)

## Connected pages

- Tests semaglutide: Semaglutide (`cardio:semaglutide`)
- Lead sponsor: Novo Nordisk (`cardio:novo-nordisk`)
- Studies people with this condition: Obesity (`core:obesity`)
- The Wegovy label reports this trial (NCT03574597) in its clinical studies: Semaglutide injection for weight management (Wegovy) (`cardio:wegovy`)

## Provenance

Content hash: 0ccac3808c24f63eec4bb4dae27a72a6df6bf81a994fc282cc55cacf3ba8da71
Last substantive edit: 2026-10-15
Evidence last checked: Not recorded