Tirzepatide significantly reduces cardiovascular risk in high-risk patients

Two new studies show that tirzepatide, a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist (RA), significantly reduces cardiovascular risk in high-risk patients, including those undergoing percutaneous coronary intervention (PCI) and those with obesity undergoing transcatheter aortic valve replacement (TAVR). 

Clinicians commonly prescribe tirzepatide for type 2 diabetes, but its metabolic benefits have drawn broader attention. By improving blood sugar levels and promoting weight loss, tirzepatide also delivers meaningful cardiovascular benefits. While prior studies have established these benefits, researchers have not extensively evaluated their impact in patients undergoing interventional cardiology procedures.

GLP-1 agonists represent an important evolution in cardiometabolic care. Clinicians already recognize the benefits of glycemic control and weight reduction, but we are now beginning to understand how these therapies can improve outcomes in patients undergoing transcatheter cardiovascular interventions. This year's SCAI Scientific Sessions is an important platform to further discuss these emerging areas of study."

Srihari S. Naidu, MD, MSCAI, SCAI President 

Tirzepatide reduces mortality by 62% in patients who undergo PCI compared to dulaglutide

Previous studies have demonstrated that tirzepatide outperforms dulaglutide, a GLP-1 receptor agonist that targets only GLP-1 receptors, by reducing major adverse cardiovascular events (MACE), weight, and HbA1c levels. However, researchers lack real-world data on its effects in patients who undergo PCI. 

In this study, researchers used the TriNetX database to identify adult patients with type 2 diabetes undergoing PCI who received treatment with either tirzepatide or dulaglutide at the time of the procedure. They performed propensity score matching and assessed outcomes at one month and one year after PCI.

Among 1,281 patients, tirzepatide consistently reduced adverse outcomes compared to dulaglutide. Patients receiving tirzepatide experienced lower rates of MACE (RR 0.46; p<0.001), acute myocardial infarction (AMI) (RR 0.47; p<0.001), heart failure exacerbation (RR 0.54; p<0.001), and ventricular arrhythmias (RR 0.56; p=0.03). There was no difference in rates of stroke. At one year, tirzepatide continued to show benefits, including consistent reductions in MACE, AMI, and heart failure exacerbation and reduced mortality (RR 0.38; p<0.001), stroke (RR 0.56; p=0.01), and cardiac arrest (RR 0.32; p<0.001).

"This study provides real-world evidence comparing two commonly used diabetes medications in a high-risk population," said Revati Varma, internal medicine resident at Cook County Hospital in Chicago. "Tirzepatide consistently reduced major cardiovascular events and mortality across multiple time points, which clinicians should actively consider when selecting therapies."

Researchers emphasized the need for prospective clinical trials to confirm these findings.

Tirzepatide Reduces Risk of Major Cardiovascular Events by 30% in Patients with Obesity After TAVR

Obesity significantly increases the risk of cardiovascular disease and complications, including aortic stenosis (AS). Clinicians frequently treat severe AS with TAVR, and about 20% of patients who undergo TAVR have obesity. Because TAVR patients often present with adverse cardiometabolic profiles, clinicians need effective strategies to manage these risks. Tirzepatide is known to help with weight loss and improve cardiometabolic outcomes, but its impact on outcomes after TAVR in patients with obesity is still unclear. 

Researchers conducted a retrospective cohort study using the TriNetX Global Collaborative Network and identified adults with obesity who underwent TAVR between January 2020 and January 2025, grouping them based on tirzepatide use. Researchers evaluated clinical outcomes over one year following the procedure.

At one year, patients who did not receive tirzepatide experienced worse outcomes over time, with lower event-free survival (77.7% vs. 84.1%). These patients also faced a 54% higher risk of hospitalization for acute heart failure compared with those receiving tirzepatide (HR 1.54, 95% CI 1.11–2.13). Patients not treated with tirzepatide experienced major adverse cardiovascular events, including death, myocardial infarction, stroke, heart failure, arrhythmia, or intracerebral hemorrhage, 44% more frequently (HR 1.44, 95% CI 1.22–1.70). However, researchers observed no significant differences between groups in rates of ischemic stroke (HR 0.92, 95% CI 0.60–1.39), acute myocardial infarction (HR 1.06, 95% CI 0.61–1.84), or acute kidney injury. 

"Patients undergoing TAVR often carry a significant cardiometabolic burden, and these results suggest that targeting underlying risk factors with agents like tirzepatide could translate into meaningful clinical benefit," said Ibrahim Mortada, MD, at the University of Texas Medical Branch (UTMB) in Galveston, Texas. "The reduction in serious cardiovascular events without an increase in ischemic or renal complications provides rationale for clinicians to seriously consider adjunctive metabolic therapy."

Researchers note these findings support the need for prospective randomized trials to determine whether tirzepatide should be incorporated into routine cardiometabolic management for patients with obesity undergoing TAVR. Future work should also clarify the ideal timing of therapy, identify which patient subgroups derive the greatest benefit, and assess whether benefits extend beyond one year after the procedure.