Cardiovascular Outcomes in Semaglutide Versus Tirzepatide Users With Obesity and Atherosclerotic Disease: A Target Trial Emulation
Authors' conclusion
Among adults with overweight or obesity and ASCVD without diabetes, there was no significant difference in cardiovascular risk between semaglutide and tirzepatide.
Study context
- Population
- Individuals with overweight or obesity (BMI ≥ 27 with a diagnosis of overweight or obesity) and a history of atherosclerotic cardiovascular disease (ASCVD), without diabetes or contraindications, with continuous insurance coverage; prior GLP-1 receptor agonist or obesity medication users excluded
- Comparison
- Semaglutide versus tirzepatide
- Outcome
- Revised 5-point MACE: composite of myocardial infarction, stroke, hospitalization for heart failure or unstable angina, coronary revascularization and mortality
Methodological detailsnational claims data from Komodo Health, Cox models with inverse probability weighting
- National claims data from Komodo Health
- Cox models with inverse probability weighting
Main finding
As reported in the abstract
Hazard ratio
1.21
95% CI 0.99–1.51
Between Semaglutide and Tirzepatide
HR 1.21 (95% CI 0.99–1.51)
Secondary outcomes
Secondary outcomes (revised 3-point major adverse cardiovascular events (MACE) and individual endpoints)
- Non-significant difference between semaglutide and tirzepatide
Sensitivity analyses for revised 5-point MACE
- Directionally consistent point estimates but sensitivity to decisions surrounding early events, off-label use, analytic approach and outcome definition
Original publication
Cardiovascular Outcomes in Semaglutide Versus Tirzepatide Users With Obesity and Atherosclerotic Disease: A Target Trial Emulation. Diabetes Obes Metab. Published 10 November 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →