Cardiometabolic & kidneyResearch article
Cardiovascular and Cerebrovascular Outcomes Risk Reduction Associated With Semaglutide vs Tirzepatide
- target trial emulation study
- following TARGET framework
- TriNetX Research Network Platform
- matched 1:1 on baseline characteristics
- stratified by diabetes status
Authors' conclusion
Tirzepatide was associated with more favorable risk reduction compared with semaglutide across multiple outcomes, with effect heterogeneity by diabetes status suggesting differential treatment associations across these populations.
Study context
- Population
- Adults initiating semaglutide or tirzepatide, stratified by type 2 diabetes statusadults initiating semaglutide or tirzepatide, matched pairs by diabetes status · type 2 diabetes (matched pairs) 48,507 · nondiabetic (matched pairs) 60,453
- Participants
- 217,920 adults
- Comparison
- semaglutide vs tirzepatide, stratified by type 2 diabetes status
- Outcome
- Primary outcomes: atrial fibrillation, heart failure (HF), and acute myocardial infarction
- Follow-up
- 1 and 3 years
Main finding
As reported in the abstract
Each group vs semaglutideRisk ratio (95% CI)
HF at 1 year, diabetic patients — tirzepatiderisk difference 1.5% (lower with tirzepatide)
0.82(0.78–0.86)
HF at 1 year, nondiabetic patients — tirzepatiderisk difference 0.9% (lower with tirzepatide)
0.60(0.55–0.65)
Secondary outcomes
Secondary outcomes: ischemic stroke/transient ischemic attack, hemorrhagic stroke, and peripheral artery disease · 1 and 3 years
- Tirzepatide was associated with a lower risk across all outcomes at 1 and 3 years
Original publication
Cardiovascular and Cerebrovascular Outcomes Risk Reduction Associated With Semaglutide vs Tirzepatide. JACC Adv. doi:10.1016/j.jacadv.2026.102917
Summarised from the published abstract; every number is checked against it