Tirzepatide linked to better outcomes for heart patients with type 2 diabetes
Tirzepatide is associated with key benefits when prescribed to heart patients with type 2 diabetes (T2D), according to a new study published in The BMJ.[1]
Tirzepatide is a popular GLP-1 drug sold by Eli Lilly under the brand names Zepbound and Mounjaro. To learn more about the medication’s impact on outcomes, researchers explored data from more than 50,000 patients over the age of 40 years old with T2D and atherosclerotic cardiovascular disease (ASCVD). While approximately two-thirds of patients were given tirzepatide, the other one-third was given sitagliptin, an older T2D medication serving as the study’s placebo proxy. All data came from two separate national U.S. administrative databases.
“A validated placebo proxy is an active comparator the cardiovascular neutrality of which has been shown in a dedicated placebo controlled outcomes trial and further corroborated in empirical benchmarking studies against placebo arms from randomized trials,” wrote first author Nils Krüger, MD, MPH, a researcher with Brigham and Women’s Hospital in Boston, and colleagues. “Such proxies are used in observational settings to approximate the counterfactual comparison with placebo that would otherwise require a randomized trial.”
Krüger et al. followed each patient for up to one year. The study’s primary outcome was major adverse cardiovascular events (MACE), a composite of myocardial infarction (MI), stroke and all-cause mortality.
Overall, one-year MACE rates were 2.9% for patients on tirzepatide and 4.4% for patients on sitagliptin. Looking at each component of that primary outcome separately, tirzepatide was linked to a reduced MI risk. There was no such benefit in terms of stroke risk. All-cause mortality, infection-related hospitalizations and infection-related mortality were all also less common among patients given tirzepatide.
“Consistent with trials of GLP-1 based treatments, the early divergence of cardiovascular event curves starting before meaningful weight loss could have taken place suggests mediators beyond weight reduction,” the authors wrote. “Such early effects may reflect improvements in systemic and vascular inflammation that act independently of metabolic benefits. Clinically, this observation may prompt prescribers to reconceptualize incretin drugs as cardiometabolic treatments capable of conferring early vascular protection rather than solely as agents for glucose or weight control.”
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Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.