Heart failure & cardiomyopathiesSecondary analysis

Influence of Type 2 Diabetes on the Effects of Tirzepatide in Patients With Heart Failure and a Preserved Ejection Fraction With Obesity

J Am Coll CardiolPublished

  • Secondary analysis of the SUMMIT randomised trial
  • double-blind
  • subgroup analysis by diabetes status

Authors' conclusion

Despite less pronounced weight loss, patients with HFpEF, obesity, and type 2 diabetes responded favorably to tirzepatide.

Study context

Population
Patients with HFpEF and BMI ≥30 kg/m², with or without T2DM1:1 randomised
Participants
731 patients
Comparison
Tirzepatide vs placebo, by type 2 diabetes status
Primary endpoint
Time to first CV death or worsening HF event; change in KCCQ Clinical Summary Score
Follow-up
52 weeks (KCCQ-CSS)

Primary result

As reported in the abstract

CV death or worsening HF event, by diabetes status
Tirzepatide vs PlaceboHazard ratio (95% CI)
with diabetes
0.64(0.35–1.15)
without diabetes
0.61(0.33–1.10)

Further findings

OutcomeValuesHR (95% CI)P value
CV death or worsening HF event (overall) · primarily fewer worsening HF events0.62 (0.41–0.95)P = 0.026
OutcomeValuesEstimateP value
Body weight loss, by diabetes status · 52 weeksWith diabetes 10.4% (95% CI 8.7%–12.2%) · Without diabetes 12.9% (95% CI 11.2%–14.6%)
  • Body weight loss, by diabetes status: interaction P = 0.04

Paracardiac fat and LV mass (CMR), by diabetes status · 52 weeks

Similar decreases in patients with or without diabetes

Original publication

Influence of Type 2 Diabetes on the Effects of Tirzepatide in Patients With Heart Failure and a Preserved Ejection Fraction With Obesity. J Am Coll Cardiol. Published 9 September 2025. doi:10.1016/j.jacc.2025.06.058

Summarised from the published abstract; every number is checked against it