Heart failure & cardiomyopathiesSecondary analysis
Effects of tirzepatide on circulatory overload and end-organ damage in heart failure with preserved ejection fraction and obesity: a secondary analysis of the SUMMIT trial
- Secondary analysis of the SUMMIT randomised trial
- mechanistic secondary analysis
Authors' conclusion
In conclusion, tirzepatide reduced circulatory volume-pressure overload and systemic inflammation and mitigated cardiovascular-kidney end-organ injury in patients with HFpEF and obesity, providing new insights into the mechanisms of benefit from tirzepatide.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) and obesity
- Participants
- 364 vs 367
- Comparison
- Tirzepatide vs placebo
- Tirzepatiden = 364
- Placebon = 367reference
Primary result
As reported in the abstract
SBP, estimated blood volume and C-reactive protein (circulatory overload and inflammation) · 52 weeks
Tirzepatide vs PlaceboETD, mmHg (95% CI)P value
SBP
−5(−7 to −3)
P < 0.001Tirzepatide vs PlaceboETD, l (95% CI)P value
estimated blood volume
−0.58(−0.63 to −0.52)
P < 0.001Tirzepatide vs PlaceboETD (95% CI)P value
C-reactive protein
−37.2%(−45.7 to −27.3)
P < 0.001Further findings
| Outcome | ETD (95% CI) | P value | |
|---|---|---|---|
| Urine albumin-creatinine ratio · 24 weeks | −25.0% (−36 to −13%) | P < 0.001 | |
| Urine albumin-creatinine ratio · 52 weeks | −15% (−28 to 0.1) | P = 0.051 | |
| −40−20020Difference (linear scale) |
Correlations (post hoc exploratory)
- Decreased estimated blood volume correlated with decreased BP, reduced microalbuminuria, improved KCCQ Clinical Summary Score and increased 6-min walk distance
- Decreased C-reactive protein correlated with reduced troponin T and improved 6-min walk distance
- post hoc exploratory
Original publication
Effects of tirzepatide on circulatory overload and end-organ damage in heart failure with preserved ejection fraction and obesity: a secondary analysis of the SUMMIT trial. Nat Med. Published 17 November 2024. doi:10.1038/s41591-024-03374-z
Summarised from the published abstract; every number is checked against it