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Cerebral edema leads to a rapid increase in intracranial pressure (ICP), which in turn compresses normal brain tissue and cerebral blood vessels, resulting in reduced cerebral perfusion pressure (CPP) and secondary ischemic injury (164)

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SELECT Trial: The Evidence for CV Coverage The SELECT trial (published in NEJM, November 2023) demonstrated that Wegovy reduces cardiovascular events: [27] 20% reduction in major adverse cardiovascular events (MACE) Includes heart attacks, strokes, and cardiovascular death 17,604 participants followed for ~3.3 years All participants had established cardiovascular disease plus obesity/overweight Typical Plan Coverage Criteria for CV Indication Medicare plans that cover Wegovy for cardiovascular risk reduction typically require: Clinical Criteria Established cardiovascular disease (prior heart attack, stroke, or peripheral artery disease) BMI (body mass index) 27 kg/m No Type 2 diabetes (or T2D not adequately controlled) Concurrent lifestyle modifications (diet and exercise) Required Documentation Cardiology records documenting established CVD Current BMI (height and weight within last 30 days) Letter of Medical Necessity from cardiologist or primary care provider Documentation of lifestyle modification attempts ICD-10 Codes for CV vs