Use of semaglutide after acute coronary syndrome: an exploratory retrospective study.
Semaglutide, a glucagon-like peptide-1 receptor agonist, has demonstrated cardiovascular benefit in patients with type 2 diabetes mellitus (T2DM) and established atherosclerotic disease. Its role in the immediate postacute coronary syndrome (ACS) setting, however, remains unexplored. This study evaluated the early real-world use of semaglutide prescribed at hospital discharge after ACS.
We conducted a retrospective, multicenter observational study of adults with T2DM hospitalized for ACS between January 2022 and December 2024 and discharged with a prescription for semaglutide. Baseline demographics, therapies, and ACS features were collected together with follow-up data on treatment persistence, reasons for discontinuation, adverse events, metabolic parameters, and cardiovascular outcomes.
A total of 60 patients (mean age 61.1 ± 10.8 years, 73% male) were included. At discharge, all received semaglutide (83.3% injectable, 16.7% oral) at the lowest dose. At the first follow-up (108 ± 39 days), 81% remained on therapy; discontinuations occurred mainly for gastrointestinal intolerance (15%). Body weight decreased by 4.7 ± 1.6 kg, BMI decreased by 1.7 ± 0.6 kg/m2, and HbA1c improved from 64.3 ± 18.2 to 49.6 ± 10.4 mmol/mol. At the second follow-up (278 ± 60 days, n = 39), 97.4% were still on semaglutide. Additional weight loss (-2.6 ± 3.8 kg) and further HbA1c reduction (40.5 ± 18.6 mmol/mol) were observed. No cardiovascular events, renal decline, or pancreatic events were reported.
In this exploratory real-world cohort, initiating semaglutide at hospital discharge after ACS was feasible, well tolerated, and associated with high persistence and early cardiometabolic improvements.
We conducted a retrospective, multicenter observational study of adults with T2DM hospitalized for ACS between January 2022 and December 2024 and discharged with a prescription for semaglutide. Baseline demographics, therapies, and ACS features were collected together with follow-up data on treatment persistence, reasons for discontinuation, adverse events, metabolic parameters, and cardiovascular outcomes.
A total of 60 patients (mean age 61.1 ± 10.8 years, 73% male) were included. At discharge, all received semaglutide (83.3% injectable, 16.7% oral) at the lowest dose. At the first follow-up (108 ± 39 days), 81% remained on therapy; discontinuations occurred mainly for gastrointestinal intolerance (15%). Body weight decreased by 4.7 ± 1.6 kg, BMI decreased by 1.7 ± 0.6 kg/m2, and HbA1c improved from 64.3 ± 18.2 to 49.6 ± 10.4 mmol/mol. At the second follow-up (278 ± 60 days, n = 39), 97.4% were still on semaglutide. Additional weight loss (-2.6 ± 3.8 kg) and further HbA1c reduction (40.5 ± 18.6 mmol/mol) were observed. No cardiovascular events, renal decline, or pancreatic events were reported.
In this exploratory real-world cohort, initiating semaglutide at hospital discharge after ACS was feasible, well tolerated, and associated with high persistence and early cardiometabolic improvements.
Authors
Biasin Biasin, Stratinaki Stratinaki, Cordioli Cordioli, Armani Armani, De Giovanni De Giovanni, Aletras Aletras, Betta Betta, Callegarin Callegarin, Gambaro Gambaro, Morani Morani
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