Cardiovascular Outcomes in Adults With Type 2 Diabetes Treated With Tirzepatide: A Systematic Review and Meta-Analysis of Real-World Studies
Authors' conclusion
Tirzepatide offers the potential to reduce the risks of ACS, HF, stroke, MACE, and death in real-world patients with T2D, suggesting CV benefits. Larger trials are needed to confirm long-term CV effects and define its role in T2D and CV management.
Study context
- Population
- Individuals with T2D receiving tirzepatide in real-world observational studies
- Participants
- 118,252 individuals8 retrospective cohort studies
- Comparison
- Tirzepatide vs control
- Outcome
- Co-primary: acute coronary syndrome (ACS), HF, sudden cardiac death and stroke
Methodological detailsrandom-effects models
- Random-effects models
Pooled result
As reported in the abstract
Co-primary outcomes: ACS, HF, sudden cardiac death, stroke
Each group vs controlEstimate (95% CI)P value
Tirzepatide
HR (ACS) 0.74(0.62–0.89)
P = 0.001Tirzepatide
HR (HF) 0.65(0.53–0.82)
P = 0.0002Tirzepatide
HR (stroke) 0.71(0.62–0.81)
P < 0.00001Further pooled results
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| MACE | 0.72 (0.60–0.86) | P = 0.0004 | |
| All-cause mortality | 0.49 (0.37–0.67) | P < 0.00001 | |
| Composite of all-cause mortality plus CV outcomes | 0.65 (0.54–0.79) | P < 0.0001 | |
| 0.20.5125Hazard ratio (log scale) |
Tirzepatide vs semaglutide
- Tirzepatide had lower risks of stroke and major adverse cardiovascular events (MACE) but similar risks for acute coronary syndrome (ACS), heart failure (HF), sudden cardiac death, all-cause mortality and composite outcomes vs semaglutide
Original publication
Cardiovascular Outcomes in Adults With Type 2 Diabetes Treated With Tirzepatide: A Systematic Review and Meta-Analysis of Real-World Studies. Endocr Pract. Published 24 November 2025. doi:10.
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