{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:02:46Z","timestamp":1786122166046,"version":"build-2736575974"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare cardiovascular outcomes associated with tirzepatide versus glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101 RAs) in adults with overweight or obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>PubMed\/MEDLINE, Embase and the Cochrane Central Register of Controlled Trials were searched through 30 March 2026. The study was registered in PROSPERO (CRD420261354941). Randomized and observational studies comparing tirzepatide with GLP\u20101 receptor agonists and reporting cardiovascular outcomes were included. Data were extracted on study characteristics and outcomes using adjusted hazard ratios when available. Risk of bias was assessed using RoB 2 and ROBINS\u2010I.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight studies (one randomized and seven observational) including 323\u2009439 patients were analysed. Tirzepatide was not associated with a statistically significant reduction in major adverse cardiovascular events (MACE) compared with GLP\u20101 receptor agonists (HR 0.85, 95% CI 0.70\u20131.04;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200990.4%). Substantial heterogeneity was observed. Effect estimates were directionally consistent across secondary outcomes, including all\u2010cause mortality (HR 0.90, 95% CI 0.79\u20131.02) and cardiovascular mortality (HR 0.88, 95% CI 0.76\u20131.00). In exploratory subgroup analyses, patients with type 2 diabetes showed lower estimated risks of all\u2010cause mortality (HR 0.85, 95% CI 0.76\u20130.94) and heart failure (HR 0.75, 95% CI 0.58\u20130.97).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tirzepatide was not associated with a statistically significant reduction in MACEs. Although effect estimates were directionally consistent across analyses, substantial heterogeneity and the predominance of observational studies limit causal interpretation. Further randomized trials are needed to clarify the comparative cardiovascular effects of tirzepatide.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71051","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T03:30:44Z","timestamp":1783395044000},"page":"8627-8636","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cardiovascular Outcomes With Tirzepatide Versus\n                    <scp>GLP<\/scp>\n                    \u20101 Receptor Agonists in Overweight or Obesity: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4395-4851","authenticated-orcid":false,"given":"Jo\u00e3o Pedro Machado Ribeiro Jacintho","family":"Silva","sequence":"first","affiliation":[{"name":"Universidade Federal do Rio de Janeiro  Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno Viruez","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo  S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah Lomelino","family":"Sartori","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro  Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Rizzo Cardoso","family":"da Silva","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro  Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucca Biagio Argenton","family":"Sciota","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro  Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar In\u00e1cio","family":"de Mendon\u00e7a Bisneto","sequence":"additional","affiliation":[{"name":"Universidade Federal de Campina Grande  Cajazeiras Para\u00edba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilton Francisco","family":"Gomes","sequence":"additional","affiliation":[{"name":"Instituto de Neurologia e Cardiologia de Curitiba  Curitiba Paran\u00e1 Brazil"},{"name":"Faculdades Pequeno Pr\u00edncipe  Curitiba Paran\u00e1 Brazil"},{"name":"Hospital INC  Curitiba Paran\u00e1 Brazil"},{"name":"Irmandade da Santa Casa de Miseric\u00f3rdia de Curitiba  Curitiba Paran\u00e1 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