Study finds tirzepatide users had fewer major cardiovascular events than sitagliptin users.
A new study has found that adults with type 2 diabetes and known heart disease who started tirzepatide had fewer major heart-related events during the first year than similar patients taking sitagliptin. Tirzepatide is a prescription medication that mimics two hormones, GIP and GLP-1, which help regulate blood sugar, reduce appetite, and slow digestion. It is used to treat type 2 diabetes and, under specific brand indications, for chronic weight management. The findings add to growing evidence about the possible heart benefits of tirzepatide as well, supporting claims that the drug can be effective for a wide range of health conditions.
In the current study, researchers examined health insurance claims from two large U.S. databases covering the three-year span between May 2022 and May 2025. The study included adults age 40 and older who had type 2 diabetes and a history of atherosclerotic cardiovascular disease, meaning disease caused by fatty buildup in the arteries. Patients also had a body mass index of at least 25. The researchers compared people who began tirzepatide with people who began sitagliptin. Sitagliptin was used as a comparison drug because earlier research has found no major effect on heart-related outcomes when compared with a placebo. The researchers used statistical methods to make the two groups as similar as possible before comparing their results.
Before the statistical adjustment, 35,353 people had started tirzepatide and 17,618 had started sitagliptin. After the groups were balanced, 7,442 patients remained in each group for the main analysis. The average age was about 70, and just over half were women. Most patients were also taking statins, while smaller portions were using insulin or newer diabetes drugs known as SGLT2 inhibitors. Over the course of one year, 2.9% of patients in the tirzepatide group experienced a major cardiovascular event, compared with 4.4% of those taking sitagliptin. The researchers calculated a hazard ratio of 0.68, meaning the tirzepatide group had a 32% lower rate of the combined outcome during the study period.
The combined outcome included stroke, heart attack, and death from any cause. The strongest differences appeared in heart attacks and deaths. The rate of heart attack was lower among patients taking tirzepatide, while the difference in stroke was much smaller and did not appear meaningful. When deaths were removed from the combined measure, heart attack or stroke still occurred less often among those taking tirzepatide. The study also found fewer infections requiring hospitalization among people taking tirzepatide than the alternative. Deaths linked to infections were also lower in that group.
The findings do not prove that tirzepatide directly prevents heart attacks or extends life. The research was based on insurance claims rather than a randomized clinical trial in which patients are assigned to same-time treatments by chance. Claims records can also contain errors or missing information. In addition, the comparison involved an injectable drug and an oral drug, and the study followed patients for a relatively short period. The results may not apply to people without established heart disease or to patients outside the insured U.S. population studied. The study also found no meaningful difference in gastrointestinal side effects between the two groups. Researchers checked several unrelated health conditions as a test of whether hidden differences between the groups might be affecting the results, and those checks did not show concerning patterns.
For adults with type 2 diabetes and existing artery disease, the results may add to discussions about treatment choices. Still, decisions about starting or changing medication depend on a person’s health history, other medicines, side effects, and advice from an individual’s medical provider.
Sources:
Tirzepatide lowers heart attack and cardiovascular event risk in adults with type 2 diabetes
Tirzepatide and the risk of atherosclerotic cardiovascular events: population based cohort study
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