Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.
The bit I cannot resolve on my own is how much of the SELECT benefit is plausibly independent of the weight loss, and whether that distinction changes anything practical.
I would rather have one careful answer than five confident ones.
pat_auckland said:Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.
Cardiac biomarkers and cardiovascular risk: my cardiologist ordered advanced cardiac labs given my family history. Results were encouraging:
- NT-proBNP: 49 pg/mL (normal, cardiac function preserved)
- Lp(a): 39 nmol/L (genetic, unchanged — expected)
- ApoB: dropped from 154 to 89 mg/dL (excellent response)
- Coronary calcium score: 0 (unchanged from baseline — reassuring)
The ApoB reduction is particularly meaningful — it's considered the best single predictor of cardiovascular risk. GLP-1 therapy seems to improve this consistently.
Dr.ObesityMed said:Cardiac biomarkers and cardiovascular risk: my cardiologist ordered advanced cardiac labs given my family history.
SUSTAIN-6 was the first CVOT to show cardiovascular benefit with semaglutide, relevant to cardiovascular risk. In 3,297 T2DM patients with high CV risk: MACE HR 0.74 (95% CI 0.58-0.95, p=0.02)[1].
Notable: the retinopathy signal in SUSTAIN-6 (HR 1.76) was subsequently attributed to rapid A1C reduction in patients with pre-existing retinopathy — not a direct drug effect. This has been confirmed in longer-term follow-up studies.
[1] Marso SP, et al. N Engl J Med. 2016;375(19):1834-1844.
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Browse GL Biochempat_auckland said:Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.
Same pattern here, and in the same order. The detail I would add is minor and it is already implied above.
Clinical perspective, offered as context rather than as advice.
CRP reduction on cardiovascular risk — this is the lab result that excites me most:
Baseline hsCRP: 5.0 mg/L (high cardiovascular risk)
Month 6 hsCRP: 3.5 mg/L (moderate risk)
Month 12 hsCRP: 0.7 mg/L (low risk)
This level of inflammatory marker reduction is comparable to what you'd see with statin therapy. Combined with the weight loss, my 10-year ASCVD risk score dropped from 12% to 6%. My cardiologist is genuinely impressed.