Evidence map›Paper›PMID 41622983›Full record

ArticleDiabetes, obesity & metabolism2026

Risk stratification using coronary artery calcium and potential benefit of semaglutide therapy: A cost-effectiveness modelling study.

Sai Rahul Ponnana, Tong Zhang, Santosh Kumar Sirasapalli, Zhuo Chen, Jean-Eudes Dazard, Niketh Surya, Shamsa Elhussain, Kanimozhi Sivanantham, Robert Okyere, Ian J Neeland and 2 more

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Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Sai Rahul PonnanaCase School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Tong ZhangCase School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Santosh Kumar SirasapalliCase School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Zhuo ChenCase School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Jean-Eudes DazardCase School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Niketh SuryaCase School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Shamsa ElhussainDepartment of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Kanimozhi SivananthamHarrington Heart and Vascular Institute, University Hospitals, Cleveland, Ohio, USA.
Robert OkyereDepartment of Internal Medicine, University Hospitals, Cleveland, Ohio, USA.
Ian J NeelandDepartment of Internal Medicine, University Hospitals, Cleveland, Ohio, USA.
Sanjay RajagopalanCase School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Salil V DeoCase School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.ORCID 0000-0002-4729-1461

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimCoronary artery calcium (CAC) scoring is observed to improve risk stratification for major adverse cardiovascular events (MACE). Semaglutide, a recently introduced anti-obesity drug, is very effective, but wider use is limited due to high costs. Hence, this study investigated the cost-effectiveness (CEA) of semaglutide across CAC groups. MATERIALS AND

methodsCAC scores for 38 058 CLARIFY registry participants meeting SELECT criteria were included. They were stratified into four CAC groups: 0, 1-99, 100-399, ≥400. To determine MACE (composite of myocardial infarction, heart failure, stroke or all-cause mortality) risk across CAC groups, hazard ratios (HR) were estimated from multi-variable adjusted Cox proportional hazard models. Next, lifetime-horizon Markov models were created to simulate semaglutide therapy and the potential clinical benefit (reported as number needed to treat [NNT]) and CEA (estimated with incremental cost-effectiveness ratio [ICER]) were examined for CAC groups. Multiple scenarios to mimic real-world experience were fitted for robust sensitivity analyses.

resultsCompared to CAC = 0, MACE risk was higher for CAC ≥400 (HR: 1.97 [95% CI: 1.66-2.35]), heart failure (HR: 1.76 [95% CI: 1.36-2.28]), mortality (HR: 1.62 [95% CI: 1.21-2.17]). Modelling 3.3 years of semaglutide use resulted in potential MACE NNT values of 151 (95% CI: 108-302) and 34 (95% CI: 25-69) for CAC = 0 and CAC ≥400. Markov modelled ICER for semaglutide use reduced across CAC groups ($625 863/QALY [CAC = 0] vs. $168 666/QALY [CAC ≥400]).

conclusionsCAC scores have potential use as a tool to estimate potential clinical benefit and cost for lifetime semaglutide therapy among obese individuals.

Indexed as

Coronary Artery DiseaseCoronary VesselsGlucagon-Like PeptidesHypoglycemic AgentsVascular CalcificationAgedCalciumCost-Benefit AnalysisCost-Effectiveness AnalysisDiabetes Mellitus, Type 2FemaleHumansMaleMiddle AgedRisk AssessmentSemaglutideCalciumGlucagon-Like PeptidesHypoglycemic AgentsSemaglutideantiobesity drugcohort studydatabase researchrisk predictionsemaglutide

Identifiers

PMID41622983
PMCPMC12992155

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