{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:45:28Z","timestamp":1792025128330,"version":"4.4.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The impact of tirzepatide and dulaglutide on major adverse cardiovascular events (MACE) and heart failure (HF) outcomes according to HF status is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Patients with type 2 diabetes (T2D) and atherosclerotic cardiovascular disease were treated with tirzepatide up to 15\u2005mg or dulaglutide 1.5\u2005mg weekly (average 4 years). The incidence of MACE-3 [cardiovascular (CV) death, myocardial infarction (MI), stroke], MACE-4 (CV death, MI, stroke, coronary revascularization) and composite of all-cause or CV death and hospitalization or urgent visits for HF were analysed in patients with and without a history of HF. A history of HF (20.3%) was associated with more coronary artery disease and prior MI. Incidences of event categories were higher in the HF group. The hazard ratio (HR) for all-cause death or hospitalization or urgent visits for HF on tirzepatide vs. dulaglutide was 0.83 [95% confidence interval (CI) 0.70\u20130.99] in patients with HF and 0.88 (95%CI 0.78\u20131.00) without HF. The HR for CV death or hospitalization or urgent visits for HF was 0.85 (95%CI 0.70\u20131.03) and 0.96 (95%CI 0.83\u20131.12), for MACE-3 0.90 (95%CI 0.76\u20131.08) and 0.93 (95%CI 0.83\u20131.04), and for MACE-4 0.81 (95%CI 0.69\u20130.95) and 0.91 (95%CI 0.83\u20131.00) in patients with and without HF, respectively. The patient-reported outcomes of APPADL and EQ-5D-5L visual analogue scores improved and were higher on tirzepatide in both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>With overall non-inferiority established, this exploratory analysis revealed lower rates of the composite of all-cause death or HF events, or MACE-4 among patients with T2D and HF treated with tirzepatide compared with dulaglutide.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag452","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:14:09Z","timestamp":1788520449000},"source":"Crossref","is-referenced-by-count":0,"title":["Outcomes in patients with diabetes, atherosclerotic cardiovascular disease, and heart failure treated with tirzepatide or dulaglutide: SURPASS-CVOT analysis"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9668-4368","authenticated-orcid":false,"given":"Stephen J","family":"Nicholls","sequence":"first","affiliation":[{"name":"Victorian Heart Institute, Monash University , 631 Blackburn Road, Melbourne 3168 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2016-7049","authenticated-orcid":false,"given":"Imre","family":"Pavo","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company , Indianapolis, IN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-6245","authenticated-orcid":false,"given":"Deepak L","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9723-3876","authenticated-orcid":false,"given":"John B","family":"Buse","sequence":"additional","affiliation":[{"name":"University of North Carolina , Chapel Hill, NC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5388-0270","authenticated-orcid":false,"given":"Stefano","family":"Del Prato","sequence":"additional","affiliation":[{"name":"Interdisciplinary Research Center \u2018Health Science\u2019, Sant\u2019Anna School of Advanced Studies , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4961-0638","authenticated-orcid":false,"given":"Denise R","family":"Franco","sequence":"additional","affiliation":[{"name":"CPCLIN\/DASA Clinical Research Center , Sao Paulo ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7307-9002","authenticated-orcid":false,"given":"Steven E","family":"Kahn","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, VA Puget Sound Health Care System and University of Washington , Seattle, WA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8175-2121","authenticated-orcid":false,"given":"A Michael","family":"Lincoff","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Fonseca","family":"Martins","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company , Indianapolis, IN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6412-7989","authenticated-orcid":false,"given":"Darren K","family":"McGuire","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center and Parkland Health and Hospital System , Dallas, TX , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3762-2618","authenticated-orcid":false,"given":"Vimal","family":"Mehta","sequence":"additional","affiliation":[{"name":"G.B. Pant Institute of Postgraduate Medical Education & Research , New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7867-0100","authenticated-orcid":false,"given":"Debra","family":"Miller","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company , Indianapolis, IN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5749-6954","authenticated-orcid":false,"given":"Michael A","family":"Nauck","sequence":"additional","affiliation":[{"name":"Diabetes, Endocrinology and Metabolism Section, Department of Medicine, St. Josef-Hospital, Katholisches Klinikum Bochum GGmbH, Ruhr University of Bochum , Bochum ,","place":["Germany"]},{"name":"Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald , Greifswald ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company , Indianapolis, IN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7231-6464","authenticated-orcid":false,"given":"Steven E","family":"Nissen","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Coordinating Center for Clinical Research (C5 Research) and Department of Medicine, Cleveland Clinic , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9466-0939","authenticated-orcid":false,"given":"No\u00e9mi","family":"Nyolczas","sequence":"additional","affiliation":[{"name":"Central Hospital of Northern Pest - Military Hospital , Budapest 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