Heart failure & cardiomyopathiesRandomised controlled trial

Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity

N Engl J MedPublished

  • Randomised controlled trial
  • international
  • double-blind
  • placebo-controlled

Authors' conclusion

Treatment with tirzepatide led to a lower risk of a composite of death from cardiovascular causes or worsening heart failure than placebo and improved health status in patients with heart failure with preserved ejection fraction and obesity.

Study context

Population
Patients with HF, EF ≥50% and BMI ≥30 (HFpEF and obesity)
Participants
731 patients
Comparison
Tirzepatide vs placebo
  • Tirzepatiden = 364
  • Placebon = 367reference
Primary endpoint
Two primary end points: composite of adjudicated CV death or worsening HF event (time-to-first-event); change in Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS) (0–100, higher = better)
Follow-up
KCCQ-CSS: baseline to 52 weeks; median 104 weeks

Primary result

As reported in the abstract

Tirzepatide vs PlaceboHazard ratio (95% CI)P value
CV death or worsening HF event
0.62(0.41–0.95)
P = 0.026
Tirzepatide vs PlaceboBetween-group difference (95% CI)P value
KCCQ-CSS change at 52 weeks
6.9(3.3–10.6)
P < 0.001

Further findings

OutcomeTirzepatidePlaceboHR (95% CI)
Worsening HF events8.0%14.2%0.54 (0.34–0.85)
Adjudicated CV death2.2%1.4%1.58 (0.52–4.83)

Safety

Adverse events (mainly gastrointestinal) leading to discontinuation of trial drug

Original publication

Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity. N Engl J Med. Published 16 November 2024. doi:10.1056/nejmoa2410027

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