It has been previously shown that the pharmacological treatment of obesity (semaglutide) can reduce cardiovascular events in patients with cardiac failure (CF) and preserved ejection fraction (EF).
Tirzepatide, a prolonged action antagonist of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptides (GLP-1), has a cardiovascular impact we still need to elucidate.
This was a randomized, double blind study, 1:1, including patients with EF ≥50% and body mass index (BMI) ≥30. Participants were assigned to tirzepatide (up to 15 mg/week, subcutaneous) or placebo.
Primary end points were 1) cardiovascular mortality or CF worsening, and 2) change in quality of life measured with the Kansas Questionnaire.
731 patients took part in the study, and were followed up to 104 weeks. The primary outcome occurred in 9.9% of tirzepatide patients vs. 15.3% of the placebo group (HR: 0.62, CI 95%: 0.41–0.95; p = 0.026). When breaking down these results, event reduction was attributed mainly to a lower incidence of CF worsening (HR: 0.54, CI 95%: 0.34–0.85).
As regards change in quality of life, the tirzepatide group showed significant improvement, with a 6.9 score difference (CI 95%: 3.3–10.6; p < 0.001) vs. placebo patients. Non-compliance rate was 6.3%, attributed mainly to gastrointestinal adverse events.
Authors’ Conclusion: weekly treatment with tirzepatide showed significant reduction of the combined end point of cardiovascular mortality and CF worsening compared against placebo, in obese patients with preserved ejection fraction.
Presented by Milton Packer at the Scientific Sessions 2024, American Heart Association, November 2024, Chicago, EEUU.
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