Heart failure & cardiomyopathies
Influence of Type 2 Diabetes on the Effects of Tirzepatide in Patients With Heart Failure and a Preserved Ejection Fraction With Obesity: A Prespecified Stratification-Based Analysis
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)
Methodological detailsdouble-blind, subgroup analysis by diabetes status
- Double-blind
- Subgroup analysis by diabetes status
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
| Outcome | Values | HR (95% CI) | P value | |
|---|---|---|---|---|
| CV death or worsening HF event (overall) · primarily fewer worsening HF events | 0.62 (0.41–0.95) | P = 0.026 | ||
| 0.512Hazard ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| Body weight loss, by diabetes status · 52 weeks | With 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: A Prespecified Stratification-Based Analysis. J Am Coll Cardiol. Published 9 September 2025. doi:10.
Summarised from the published abstract; every number is checked against it