Heart failure & cardiomyopathiesSecondary analysis
Impact of Body Mass Index, Central Adiposity, and Weight Loss on the Benefits of Tirzepatide in Heart Failure with Preserved Ejection Fraction (HFpEF)
- Secondary analysis of the SUMMIT randomised trial
Authors' conclusion
Tirzepatide consistently reduced the risk of HF or cardiovascular death regardless of baseline BMI, but there was evidence suggesting greater improvement in 6MWD in those with higher BMI at baseline.
Study context
- Population
- NYHA class II–IV HFpEF with body mass index (BMI) ≥30 kg/m²
- Participants
- 731 participants
- Comparison
- Tirzepatide vs placebo, by baseline BMI and WHR tertile
- Tirzepatiden = 364
- Placebon = 367reference
- Primary endpoint
- Time to CV death or worsening HF and change in KCCQ-CSS, by BMI and WHR tertile
- Follow-up
- 52 weeks
Primary result
As reported in the abstract
CV death or worsening HF by BMI or WHR tertile
Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS): trend for greater improvement with increasing BMI tertile
P = 0.097
Secondary outcomes
| Outcome | Estimate | P value |
|---|---|---|
| 6MWD by increasing BMI tertile (tirzepatide vs placebo) · lowest to highest BMI tertile | ETD 9.9 vs 26.3 vs 37.5 m | P = 0.025 |
| Body weight by increasing BMI tertile · lowest to highest BMI tertile | ETD −10.7% vs −11.8% vs −14.4% | P = 0.006 |
| SBP by increasing BMI tertile · lowest to highest BMI tertile | ETD −1.00 vs −6.65 vs −6.62 mm Hg | P = 0.035 |
Weight loss and waist circumference (WC) decrease on tirzepatide · 52 weeks
- Greater weight loss associated with larger improvements in 6MWD, KCCQ-CSS, C-reactive protein (CRP) and BP; greater WC decrease associated with larger increases in 6MWD and KCCQ-CSS
Original publication
Impact of Body Mass Index, Central Adiposity, and Weight Loss on the Benefits of Tirzepatide in HFpEF. J Am Coll Cardiol. Published 29 July 2025. doi:10.1016/j.jacc.2025.04.059
Summarised from the published abstract; every number is checked against it