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Evidence-based GLP-1 & peptide discussion since 2023
ForumsCardiovascular OutcomesSELECT cost-effectiveness — need advice Page 4

SELECT cost-effectiveness — need advice

MikeKY_noInsulin Sun, Apr 6, 2025 at 12:56 AM 16 replies 1,703 viewsPage 4 of 4
DadBodDave
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Apr 10, 2025 at 5:23 AM#16
hans_munich said:
Mendelian randomization evidence supporting GLP-1 pathway modulation for cardiovascular risk: genetic variants in the GLP1R gene region associated…

Same experience, arrived at from the opposite direction. Nothing to add that would improve it.

49 22laura_annarbor, JenMemphis, pat_auckland and 46 others
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Dr.BariatricHTX
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Apr 10, 2025 at 8:28 PM#17
Dr.NateNeph said:
NNT calculation for cardiovascular risk clinical endpoints: NNT = 1/ARR (absolute risk reduction).

Can confirm. Same sequence, different timescale. Posting only so the count is not one.

Last edited: Apr 11, 2025 at 2:28 AM
50 23pete_RVA, CarlaRPh_TPA, steph_laguna and 47 others
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Dr.NephBHM_UK
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Apr 11, 2025 at 11:34 AM#18
Dr.NateNeph said:
NNT calculation for cardiovascular risk clinical endpoints: NNT = 1/ARR (absolute risk reduction).

Anti-inflammatory mechanisms of GLP-1 agonists and cardiovascular risk: beyond weight loss, GLP-1R activation directly suppresses NF-κB signaling, reduces NLRP3 inflammasome activation, and decreases monocyte/macrophage adhesion to endothelium[1].

Clinical correlates: hsCRP reduction of 30-60% (consistently seen across trials), reduced carotid intima-media thickness, and decreased coronary plaque inflammation on PET imaging.

These anti-inflammatory effects likely contribute to the cardiovascular benefit seen in SELECT — and may explain benefits beyond what weight loss alone would predict.

References:
[1] Hogan AE, et al. Diabetologia. 2014;57(4):781-784.
1 24PharmacoVig_BOS
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DataDave
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Apr 12, 2025 at 2:40 AM#19
Dr.NateNeph said:
NNT calculation for cardiovascular risk clinical endpoints: NNT = 1/ARR (absolute risk reduction).

Vitamin deficiency cascade with cardiovascular risk: after 6+ months of reduced food intake, I developed a subtle but important pattern: low B12 → elevated homocysteine → increased cardiovascular risk marker.

The connection: B12 is a cofactor for homocysteine metabolism. Without adequate B12, homocysteine accumulates. This is ironic — taking a CV-protective medication while developing a CV risk factor from reduced nutrition.

Solution: comprehensive vitamin supplementation and regular lab monitoring. Don't let the medication's benefits be undermined by nutritional deficiencies.

Last edited: Apr 12, 2025 at 3:40 AM
2 0amsterdam_pete, LondonLisa
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mike_mod
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Apr 12, 2025 at 5:46 PM#20

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. Thread quality here is what the rules are for. Keep it up.

24 22PurityPaulOR, MaxMetOK, MounjBrad and 21 others
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