Development of Cardiovascular Risk Equations in People with Overweight or Obesity and Established Cardiovascular Disease Without Diabetes Based on the SELECT Trial

We derived treatment-specific, trial-based risk eqautions to predict the risk of secondary cardiovascular events in people with overweight or obesity and established cardiovascular disease but without diabetes.

With recent advancements in weight management interventions demonstrating cardioprotective benefits, there is aneed for risk equations that can accurately predict cardiovascular event risk and the role of AOM in health economic models to support healthcare decision making and resource allocation.

Risk equations estimating first in-trial observed acute coronary syndrome and stroke were derived from patient-level data from the SELECT trial, a double-blind randomised placebo-controlled trial comparing semaglutide 2.4 mg with placebo. Risk factors were identified from the literature and by clinical experts. Risk equations were developed using cause-specific Cox proportional hazard models with all-cause mortality as a competing risk. Least absolute shrinkage and selectionoperator (LASSO) penalisation was applied 100 times in bootstrap samples to refine the risk equations. The final risk equations were validated with clinical experts and using SELECT trial data.

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Recommended citation: Bøg, M., Bojesen, A.B., Emerson, S. et al. Development of Cardiovascular Risk Equations in People with Overweight or Obesity and Established Cardiovascular Disease Without Diabetes Based on the SELECT Trial. PharmacoEconomics (2026).