GLP-1 and atrial fibrillation risk — 6 month update

Dr.LeslieOBGYN said:

My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.

I want to bring up the cardiovascular angle on cardiovascular risk.

The SELECT trial demonstrated a 20% reduction in MACE with semaglutide 2.4mg[1]. This is practice-changing because the CV benefit appears to be independent of the degree of weight loss — suggesting direct vascular and anti-inflammatory mechanisms.

For cardiovascular risk, this means we need to think beyond the primary outcome and consider the cardiovascular implications. The all-cause mortality reduction (HR 0.81) is the most clinically meaningful signal.

Dr.GutHealth said:

I want to bring up the cardiovascular angle on cardiovascular risk.

NNT calculation for cardiovascular risk clinical endpoints: NNT = 1/ARR (absolute risk reduction).

From SELECT trial: MACE at 39 months — 6.5% semaglutide vs 8.0% placebo. ARR = 1.5%. NNT = 67 over 3.3 years.

Compare to established therapies:

These NNTs are clinically meaningful and comparable to accepted cardiovascular interventions.

Dr.LeslieOBGYN said:

My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.

Same experience, arrived at from the opposite direction. Posting only so the count is not one.

Adding the clinical framing, because it changes how the question reads.

Continuous metabolic monitoring dashboard for cardiovascular risk — I track everything in a spreadsheet and here's the month-over-month trend for my key markers:

Weight: consistent downtrend, -1.7 lbs/week average
Fasting glucose (finger stick): stable at 86 mg/dL
Blood pressure (home): 117/72 average
Resting heart rate: 66 bpm (down from 82)
Waist circumference: down 16 inches total

The resting heart rate improvement correlates with cardiovascular fitness gains. Everything is moving in the right direction.