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ForumsCardiovascular OutcomesHas anyone dealt with glp-1 and peripheral arterial disease? Page 5

Has anyone dealt with glp-1 and peripheral arterial disease?

traveltech_sara Fri, Jan 31, 2025 at 6:48 PM 24 replies 2,011 viewsPage 5 of 5
gary_naperville
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Oct 2024
Naperville, IL
Feb 8, 2025 at 5:39 AM#21
DataDave said:
Continuous metabolic monitoring dashboard for cardiovascular risk — I track everything in a spreadsheet and here's the month-over-month trend for my…

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.

References:
[1] Lincoff AM, et al. N Engl J Med. 2023;389(24):2221-2232.
Last edited: Feb 8, 2025 at 8:39 AM
21 19SleepFixSam, PurityPaulOR, MaxMetOK and 18 others
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ingrid_STO
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Jul 2024
Stockholm, SE
Feb 10, 2025 at 3:57 PM#22
DataDave said:
Continuous metabolic monitoring dashboard for cardiovascular risk — I track everything in a spreadsheet and here's the month-over-month trend for my…

This answered a question I did not know how to ask. Printing the relevant bit and taking it with me.

22 20COA_Karl, MikeFit_NJ, InsuranceTom and 19 others
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MASHdoc_SA
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Feb 13, 2025 at 2:17 AM#23

Clinical perspective, offered as context rather than as advice.

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:

InterventionNNTTimeframe
Semaglutide (MACE)673.3 years
Statins primary prevention (MI)~1005 years
Aspirin secondary prevention~772 years

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

23 21JennaRN, LabKate, kate.chem and 20 others
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Dr.ObesityLA
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Los Angeles, CA
Feb 15, 2025 at 12:38 PM#24
MASHdoc_SA said:
NNT calculation for cardiovascular risk clinical endpoints: NNT = 1/ARR (absolute risk reduction).

This is my experience too, for whatever a second data point is worth.

24 22chris_chi24, tampaLisa73, KarenAZ_mom and 21 others
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PharmacoVig_BOS
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Feb 2024
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Feb 17, 2025 at 11:01 PM#25
MASHdoc_SA said:
NNT calculation for cardiovascular risk clinical endpoints: NNT = 1/ARR (absolute risk reduction).

Lp(a) and cardiovascular risk: a nuance that matters. Unlike most lipid markers, Lp(a) is 90%+ genetically determined and doesn't really change with weight loss or GLP-1 therapy.

My Lp(a) has remained at 68 nmol/L across all time points. If yours is elevated (>50 nmol/L), you need additional risk mitigation strategies regardless of your GLP-1 response. Don't assume your medication is covering all cardiovascular risk factors.

25 23LabKate, kate.chem, DataDave and 22 others
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