AIMS: Semaglutide has been shown to reduce cardiovascular events in non-diabetic patients with preexisting cardiovascular disease and overweight/obesity in the SELECT trial. Data on the applicability of these results to clinical practice are limited. We evaluated the eligibility for and practical implications of semaglutide in overweight/obese non-diabetic patients with recent acute coronary syndrome (ACS) from a contemporary real-world registry. METHODS: Patients from the multicenter START-ANTIPLATELET registry (NCT02219984) were stratified to investigate the proportion of patients eligible for semaglutide >
60 days after discharge for ACS (post-acute phase), according to the SELECT trial eligibility criteria: age ≥ 45 years
body mass index ≥27 kg/m RESULTS: The study population comprised 2940 consecutive ACS patients. At 60 days after discharge, 807 patients (27.4 %) met the SELECT eligibility criteria (SELECT-like group) and 2133 patients were ineligible (not-eligible group). At 1 year, incidence of MACE (4.6 % vs. 8.2 %
p = 0.004) and NACE (3.6 % vs. 7.6 %
p <
0.001) was lower in the SELECT-like group compared to the not-eligible group. CONCLUSIONS: In a contemporary real-world registry, a significant proportion of post-ACS patients were eligible for semaglutide according to the SELECT trial criteria. Future studies are needed to evaluate the potential implications of semaglutide for secondary prevention.