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SELECT

CompletedPhase 3Results posted

Semaglutide Effects on Heart Disease and Stroke in Patients With Overweight or Obesity

SELECT - Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity

Lead sponsor

Novo Nordisk A/S

Asset

Semaglutide

Subcutaneous · GLP-1 agonist

Listed sites

833

Recruiting sites

Enrollment

17,604

actual

Study population

Cardiovascular disease, Obesity / overweight

Key I/E criteria

BMI ≥27Established CVD

Primary endpoint

3-point MACE (Cardiovascular death, Non-fatal MI, Non-fatal stroke)

Footprint

Where this trial recruits

Site locations as reported to ClinicalTrials.gov. Site count is not enrollment count; per-site enrollment is not available from source.

Identifiers

Registered as

NCT IDNCT03574597
Org study IDEX9536-4388
Secondary ID2017-003380-35European Medicines Agency (EudraCT)
Secondary IDU1111-1200-5564World Health Organization (WHO)

Timeline

Milestones

Study first posted2018-07-02actual
Study start2018-10-24actual
Primary completion2023-06-21actual
Study completion2023-06-29actual
Last update posted2024-08-30actual
Results first posted2024-08-30actual

Assets

Investigational agents

Study populations

Who this study enrolls

Cardiovascular diseaseObesity / overweight

Eligibility

Who can enroll

Minimum age45 Years
SexAll
Healthy volunteersNot accepted

Inclusion criteria

Informed consent obtained before any trial-related activities. Trial-related activities are any procedures that are carried out as part of the trial, including activities to determine suitability for the trial
Male or female, age greater than or equal to 45 years at the time of signing informed consent
Body mass index (BMI) greater than or equal to 27 kg/m^2
Have established cardiovascular (CV) disease as evidenced by at least one of the following: prior myocardial infarction; prior stroke (ischemic or haemorrhagic stroke); or symptomatic peripheral arterial disease (PAD), as evidenced by intermittent claudication with ankle-brachial index (ABI) less than 0.85 (at rest), or peripheral arterial revascularization procedure, or amputation due to atherosclerotic disease

Exclusion criteria

Cardiovascular-related:

Any of the following: myocardial infarction, stroke, hospitalisation for unstable angina pectoris or transient ischaemic attack within the past 60 days prior to the day of screening
Planned coronary, carotid or peripheral artery revascularisation known on the day of screening
Presently classified as being in New York Heart Association (NYHA) Class IV heart failure

Glycaemia-related:

HbA1c greater than or equal to 48 mmol/mol (6.5 %) as measured by the central laboratory at screening
History of type 1 or type 2 diabetes (history of gestational diabetes is allowed)
Treatment with glucose-lowering agents within 90 days before screening
Treatment with any glucagon-like-peptide-1 receptor agonist (GLP-1 RA) within 90 days before screening

General safety:

History or presence of chronic pancreatitis
Presence of acute pancreatitis within the past 180 days prior to the day of screening
Personal or first degree relative(s) history of multiple endocrine neoplasia type 2 or medullary thyroid carcinoma
End stage renal disease or chronic or intermittent haemodialysis or peritoneal dialysis
Presence or history of malignant neoplasms within the past 5 years prior to the day of screening. Basal and squamous cell skin cancer and any carcinoma in-situ are allowed
Severe psychiatric disorder which in the investigator's opinion could compromise compliance with the protocol
Known or suspected hypersensitivity to trial products or related products
Previous participation in this trial. Participation is defined as randomisation
Receipt of any investigational medicinal product within 30 days before screening
Female who is pregnant, breast-feeding or intends to become pregnant or is of child-bearing potential and not using a highly effective contraceptive method
Any disorder, unwillingness or inability, which in the investigator's opinion, might jeopardise the participant's safety or compliance with the protocol

Endpoints (58)

What's being measured

Protocol endpoints and posted registry outcome measures, grouped into outcome categories. Composite endpoints show their component event types. Standard codes (LOINC, SNOMED CT) are shown where available.

Coverage by outcome category

Cardiovascular outcomes
18
Cardiometabolic biomarkers
16
Glycemic / diabetes
10
Weight & body composition
4
Heart failure
4
Patient-reported / QoL
4
Renal / kidney
2

Cardiovascular outcomes

18 endpoints
Primary/registry result

Participants From Time of Randomization to First Occurrence of a Composite Outcome Measure Consisting of: Cardiovascular (CV) Death, Non-fatal Myocardial Infarction (MI), or Non-fatal Stroke

Time frame:From randomisation (week 0) up to 240 weeks

3-point MACE

time to event, event

componentsCardiovascular death, Non-fatal MI, Non-fatal stroke

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide569
Placebo701
Hazard Ratio (HR)0.8095% CI0.720.89p< 0.0001Regression, Cox
Primary/protocol endpoint

Participants From Time of Randomization to First Occurrence of a Composite Outcome Measure Consisting of: Cardiovascular (CV) Death, Non-fatal Myocardial Infarction (MI), or Non-fatal Stroke

Time frame:From randomisation (week 0) up to 240 weeks

3-point MACE

time to event, event

componentsCardiovascular death, Non-fatal MI, Non-fatal stroke

Secondary/registry result

Participants From Time of Randomisation to CV Death

Time frame:From randomisation (week 0) up to 240 weeks

Cardiovascular death

time to event, event

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide223
Placebo262
Secondary/registry result

Participants From Time of Randomisation to All-cause Death

Time frame:From randomisation (week 0) up to 240 weeks

All-cause death

time to event, event

SNOMED 419620001

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide375
Placebo458
Secondary/registry result

Participants From Time of Randomisation to First Occurrence of an Expanded Composite CV Outcome Measure Consisting of: CV Death, Non-fatal MI, Non-fatal Stroke, Coronary Revascularisation or Unstable Angina Pectoris (UAP) Requiring Hospitalisation

Time frame:From randomisation (week 0) up to 240 weeks

Expanded / custom MACE composite

time to event, event

componentsCardiovascular death, Non-fatal MI, Non-fatal stroke, Coronary revascularization, Unstable angina hospitalization

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide873
Placebo1074
Secondary/registry result

Participants From Time of Randomisation to First Occurrence of a Composite Outcome Measure Consisting of: All-cause Death, Non-fatal MI, or Non-fatal Stroke

Time frame:From randomisation (week 0) up to 240 weeks

Expanded / custom MACE composite

time to event, event

componentsAll-cause death, Non-fatal MI, Non-fatal stroke

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide710
Placebo877
Secondary/registry result

Participants From Time of Randomisation to First Occurrence of Non-fatal MI

Time frame:From randomisation (week 0) up to 240 weeks

Non-fatal MI

time to event, event

SNOMED 22298006

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide234
Placebo322
Secondary/registry result

Participants From Time of Randomisation to First Occurrence of Non-fatal Stroke

Time frame:From randomisation (week 0) up to 240 weeks

Non-fatal stroke

time to event, event

SNOMED 230690007

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide154
Placebo165
Secondary/registry result

Participants From Time of Randomisation to First Occurrence of Coronary Revascularisation

Time frame:From randomisation (week 0) up to 240 weeks

Coronary revascularization

time to event, event

SNOMED 415070008

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide473
Placebo608
Secondary/registry result

Participants From Time of Randomisation to First Occurrence of UAP Requiring Hospitalisation

Time frame:From randomisation (week 0) up to 240 weeks

Unstable angina hospitalization

time to event, event

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide109
Placebo124
Secondary/protocol endpoint

Participants From Time of Randomisation to CV Death

Time frame:From randomisation (week 0) up to 240 weeks

Cardiovascular death

time to event, event

Secondary/protocol endpoint

Participants From Time of Randomisation to All-cause Death

Time frame:From randomisation (week 0) up to 240 weeks

All-cause death

time to event, event

SNOMED 419620001

Secondary/protocol endpoint

Participants From Time of Randomisation to First Occurrence of an Expanded Composite CV Outcome Measure Consisting of: CV Death, Non-fatal MI, Non-fatal Stroke, Coronary Revascularisation or Unstable Angina Pectoris (UAP) Requiring Hospitalisation

Time frame:From randomisation (week 0) up to 240 weeks

5-point MACE

time to event, event

componentsCardiovascular death, Non-fatal MI, Non-fatal stroke, Coronary revascularization, Unstable angina hospitalization

Secondary/protocol endpoint

Participants From Time of Randomisation to First Occurrence of a Composite Outcome Measure Consisting of: All-cause Death, Non-fatal MI, or Non-fatal Stroke

Time frame:From randomisation (week 0) up to 240 weeks

Expanded / custom MACE composite

time to event, event

componentsAll-cause death, Non-fatal MI, Non-fatal stroke

Secondary/protocol endpoint

Participants From Time of Randomisation to First Occurrence of Non-fatal MI

Time frame:From randomisation (week 0) up to 240 weeks

Non-fatal MI

time to event, event

SNOMED 22298006

Secondary/protocol endpoint

Participants From Time of Randomisation to First Occurrence of Non-fatal Stroke

Time frame:From randomisation (week 0) up to 240 weeks

Non-fatal stroke

time to event, event

SNOMED 230690007

Secondary/protocol endpoint

Participants From Time of Randomisation to First Occurrence of Coronary Revascularisation

Time frame:From randomisation (week 0) up to 240 weeks

Coronary revascularization

time to event, event

SNOMED 415070008

Secondary/protocol endpoint

Participants From Time of Randomisation to First Occurrence of UAP Requiring Hospitalisation

Time frame:From randomisation (week 0) up to 240 weeks

Unstable angina hospitalization

time to event, event

Weight & body composition

4 endpoints
Secondary/registry result

Change in Body Weight

Time frame:Week 0, week 104

Body weight, % change

percent change from baseline, improvement

Posted result

GroupValue (mean), percentage change in body weight95% CI
Semaglutide-9.39
Placebo-0.87
Secondary/registry result

Change in Waist Circumference

Time frame:Week 0, week 104

Waist circumference, change

change from baseline, improvement

Posted result

GroupValue (mean), centimeter (cm)95% CI
Semaglutide-7.5
Placebo-1.0
Secondary/protocol endpoint

Change in Body Weight

Time frame:Week 0, week 104

Body weight, % change

percent change from baseline, improvement

Secondary/protocol endpoint

Change in Waist Circumference

Time frame:Week 0, week 104

Waist circumference, change

change from baseline, improvement

Glycemic / diabetes

10 endpoints
Secondary/registry result

Participants From Time of Randomisation to First Occurrence of Glycosylated Haemoglobin (HbA1c) Greater Than Equals to (≥) 48 Millimole Per Mole (mmol/Mol) (6.5 Percentage [%])

Time frame:From randomisation (week 0) up to 240 weeks

HbA1c <6.5% achievement

threshold achievement, improvement

LOINC 4548-4

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide306
Placebo1059
Secondary/registry result

Participants From Time of Randomisation to HbA1c ≥ 39 mmol/Mol (5.7%) (for Participants With a Screening HbA1c <39 mmol/Mol [5.7%])

Time frame:From randomisation (week 0) up to 240 weeks

HbA1c <5.7% achievement

threshold achievement, improvement

LOINC 4548-4

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide623
Placebo1501
Secondary/registry result

Participants With HbA1c < 39 mmol/Mol (5.7%) (for Participants With a Screening HbA1c ≥ 39 mmol/Mol [5.7%])

Time frame:At week 52, week 104

HbA1c <5.7% achievement

threshold achievement, improvement

LOINC 4548-4

Posted result

GroupValue (count_of_participants), Participants95% CI
SemaglutideWeek 523363
Week 1043271
PlaceboWeek 52955
Week 104978
Secondary/registry result

Change in HbA1c - Percentage

Time frame:Week 0, week 104

HbA1c, change

change from baseline, improvement

LOINC 4548-4

Posted result

GroupValue (mean), Percentage of HbA1c95% CI
Semaglutide-0.31
Placebo0.01
Secondary/registry result

Change in HbA1c - mmol/Mol

Time frame:Week 0, week 104

HbA1c, change

change from baseline, improvement

LOINC 4548-4

Posted result

GroupValue (mean), mmol/mol95% CI
Semaglutide-3.38
Placebo0.10
Secondary/protocol endpoint

Participants From Time of Randomisation to First Occurrence of Glycosylated Haemoglobin (HbA1c) Greater Than Equals to (≥) 48 Millimole Per Mole (mmol/Mol) (6.5 Percentage [%])

Time frame:From randomisation (week 0) up to 240 weeks

HbA1c <6.5% achievement

time to event, event

LOINC 4548-4

Secondary/protocol endpoint

Participants From Time of Randomisation to HbA1c ≥ 39 mmol/Mol (5.7%) (for Participants With a Screening HbA1c <39 mmol/Mol [5.7%])

Time frame:From randomisation (week 0) up to 240 weeks

HbA1c <5.7% achievement

threshold achievement, improvement

LOINC 4548-4

Secondary/protocol endpoint

Participants With HbA1c < 39 mmol/Mol (5.7%) (for Participants With a Screening HbA1c ≥ 39 mmol/Mol [5.7%])

Time frame:At week 52, week 104

HbA1c <5.7% achievement

threshold achievement, improvement

LOINC 4548-4

Secondary/protocol endpoint

Change in HbA1c - Percentage

Time frame:Week 0, week 104

HbA1c, change

change from baseline, improvement

LOINC 4548-4

Secondary/protocol endpoint

Change in HbA1c - mmol/Mol

Time frame:Week 0, week 104

HbA1c, change

change from baseline, improvement

LOINC 4548-4

Heart failure

4 endpoints
Secondary/registry result

Participants From Time of Randomisation to First Occurrence of a Composite Heart Failure (HF) Outcome Measure Consisting of: HF Hospitalisation, Urgent HF Visit or CV Death

Time frame:From randomisation (week 0) up to 240 weeks

Expanded / custom MACE composite

time to event, event

componentsHeart-failure hospitalization, Urgent heart-failure visit, Cardiovascular death

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide300
Placebo361
Secondary/registry result

Participants From Time of Randomisation to First Occurrence of HF Requiring Hospitalisation or Urgent HF Visit

Time frame:From randomisation (week 0) up to 240 weeks

Heart-failure composite

time to event, event

componentsHeart-failure hospitalization, Urgent heart-failure visit

SNOMED 84114007

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide97
Placebo122
Secondary/protocol endpoint

Participants From Time of Randomisation to First Occurrence of a Composite Heart Failure (HF) Outcome Measure Consisting of: HF Hospitalisation, Urgent HF Visit or CV Death

Time frame:From randomisation (week 0) up to 240 weeks

Expanded / custom MACE composite

time to event, event

componentsHeart-failure hospitalization, Urgent heart-failure visit, Cardiovascular death

Secondary/protocol endpoint

Participants From Time of Randomisation to First Occurrence of HF Requiring Hospitalisation or Urgent HF Visit

Time frame:From randomisation (week 0) up to 240 weeks

Heart-failure composite

time to event, event

componentsHeart-failure hospitalization, Urgent heart-failure visit

SNOMED 84114007

Renal / kidney

2 endpoints
Secondary/registry result

Participants From Time of Randomisation to First Occurrence of a 5-component Composite Nephropathy Outcome Measure

Time frame:From randomisation (week 0) up to 240 weeks

5-point renal composite

time to event, event

componentsuACR, change, eGFR, change, End-stage renal disease, Kidney-replacement therapy, Renal death

Posted result

GroupValue (count_of_participants), Participants95% CI
Semaglutide155
Placebo198
Secondary/protocol endpoint

Participants From Time of Randomisation to First Occurrence of a 5-component Composite Nephropathy Outcome Measure

Time frame:From randomisation (week 0) up to 240 weeks

5-point renal composite

time to event, event

componentsuACR, change, eGFR, change, End-stage renal disease, Kidney-replacement therapy, Renal death

Cardiometabolic biomarkers

16 endpoints
Secondary/registry result

Change in Systolic Blood Pressure (SBP)

Time frame:Week 0, week 104

Systolic BP, change

change from baseline, improvement

LOINC 8480-6

Posted result

GroupValue (mean), Millimetre of mercury (mmHg)95% CI
Semaglutide-3.8
Placebo-0.6
Secondary/registry result

Change in Diastolic Blood Pressure (DBP)

Time frame:Week 0, week 104

Diastolic BP, change

change from baseline, improvement

LOINC 8462-4

Posted result

GroupValue (mean), mmHg95% CI
Semaglutide-1.1
Placebo-0.4
Secondary/registry result

Change in Pulse

Time frame:Week 0, week 104

Heart rate, change

change from baseline, improvement

Posted result

GroupValue (mean), beats per mintue (bpm)95% CI
Semaglutide3.8
Placebo0.9
Secondary/registry result

Change in High Sensitivity C-Reactive Protein (hsCRP) - Ratio to Baseline

Time frame:Week 0, week 104

hs-CRP, change

ratio, improvement

LOINC 30522-7

Posted result

GroupValue (geometric_mean), ratio of hsCRP95% CI
Semaglutide0.61
Placebo1.00
Secondary/registry result

Change in Total Cholesterol - Ratio to Baseline

Time frame:Week 0, week 104

Total cholesterol, change

ratio, improvement

LOINC 2093-3

Posted result

GroupValue (geometric_mean), ratio of total cholesterol95% CI
Semaglutide0.95
Placebo0.98
Secondary/registry result

Change in High Density Lipoprotein (HDL) Cholesterol - Ratio to Baseline

Time frame:Week 0, week 104

HDL-C, change

ratio, improvement

LOINC 2085-9

Posted result

GroupValue (geometric_mean), ratio of HDL95% CI
Semaglutide1.05
Placebo1.01
Secondary/registry result

Change in Low Density Lipoprotein (LDL) Cholesterol - Ratio to Baseline

Time frame:Week 0, week 104

LDL-C, change

ratio, improvement

LOINC 13457-7

Posted result

GroupValue (geometric_mean), ratio of LDL95% CI
Semaglutide0.95
Placebo0.97
Secondary/registry result

Change in Triglycerides - Ratio to Baseline

Time frame:Week 0, week 104

Triglycerides, change

ratio, improvement

LOINC 2571-8

Posted result

GroupValue (geometric_mean), ratio of triglycerides95% CI
Semaglutide0.82
Placebo0.97
Secondary/protocol endpoint

Change in Systolic Blood Pressure (SBP)

Time frame:Week 0, week 104

Systolic BP, change

change from baseline, improvement

LOINC 8480-6

Secondary/protocol endpoint

Change in Diastolic Blood Pressure (DBP)

Time frame:Week 0, week 104

Diastolic BP, change

change from baseline, improvement

LOINC 8462-4

Secondary/protocol endpoint

Change in Pulse

Time frame:Week 0, week 104

Heart rate, change

change from baseline, improvement

Secondary/protocol endpoint

Change in High Sensitivity C-Reactive Protein (hsCRP) - Ratio to Baseline

Time frame:Week 0, week 104

hs-CRP, change

ratio, improvement

LOINC 30522-7

Secondary/protocol endpoint

Change in Total Cholesterol - Ratio to Baseline

Time frame:Week 0, week 104

Total cholesterol, change

ratio, improvement

LOINC 2093-3

Secondary/protocol endpoint

Change in High Density Lipoprotein (HDL) Cholesterol - Ratio to Baseline

Time frame:Week 0, week 104

HDL-C, change

ratio, improvement

LOINC 2085-9

Secondary/protocol endpoint

Change in Low Density Lipoprotein (LDL) Cholesterol - Ratio to Baseline

Time frame:Week 0, week 104

LDL-C, change

ratio, improvement

LOINC 13457-7

Secondary/protocol endpoint

Change in Triglycerides - Ratio to Baseline

Time frame:Week 0, week 104

Triglycerides, change

ratio, improvement

LOINC 2571-8

Patient-reported / QoL

4 endpoints
Secondary/registry result

Change From Randomisation (Week 0) in Participant Reported Outcome (PRO): EuroQol Five Dimensions Five Level Questionnaire (EQ-5D-5L) Index Score to Week 104

Time frame:Week 0, week 104

EQ-5D index

change from baseline, improvement

Posted result

GroupValue (mean), score on a scale95% CI
Semaglutide0.01
Placebo-0.01
Secondary/registry result

Change From Randomisation (Week 0) in PRO: EuroQol Five Dimensions Visual Analogue Scale (EQ-5D-VAS) to Week 104

Time frame:Week 0, week 104

EQ-5D VAS

change from baseline, improvement

Posted result

GroupValue (mean), score on a scale95% CI
Semaglutide2.38
Placebo0.77
Secondary/protocol endpoint

Change From Randomisation (Week 0) in Participant Reported Outcome (PRO): EuroQol Five Dimensions Five Level Questionnaire (EQ-5D-5L) Index Score to Week 104

Time frame:Week 0, week 104

EQ-5D index

change from baseline, improvement

Secondary/protocol endpoint

Change From Randomisation (Week 0) in PRO: EuroQol Five Dimensions Visual Analogue Scale (EQ-5D-VAS) to Week 104

Time frame:Week 0, week 104

EQ-5D VAS

change from baseline, improvement

Publications (22)

Bibliography

Records linked to this trial through ClinicalTrials.gov references, PubMed NCT search, and curated study seeds. 'Canonical' marks design/result papers; others are registry references or candidates.

Canonical study publications

Registry references + supporting bibliography

Provenance

Sources

Trial identity, design, statusClinicalTrials.gov API v2
Snapshot dateJuly 1, 2026
Endpoint classificationDelfa endpoint taxonomy v2 (May 13, 2026)
Results tableClinicalTrials.gov results section

Trial facts come from public ClinicalTrials.gov records. Endpoint categories are Delfa's classification of those records, not a ClinicalTrials.gov field. All figures reflect the July 1, 2026 snapshot.