AHA Scientific Sessions 2025 - Dr Nils Krüger (Brigham and Women's Hospital, US) joins us to discuss findings from the TIRZSEMA-CVOT (NCT07096063) study, examining real-world cardiovascular outcomes with tirzepatide and semaglutide in patients with type 2 diabetes at cardiovascular risk.

This retrospective cohort study utilized three national US claims databases to evaluate over 887,000 patients with type 2 diabetes, overweight, and cardiovascular risk factors. The research employed a novel approach to emulate randomized controlled trials using real-world data, comparing three treatment strategies: tirzepatide versus dulaglutide, semaglutide versus sitagliptin, and tirzepatide versus semaglutide. The study specifically focused on patients typically encountered in routine clinical practice, including those who might not meet the strict eligibility criteria of pivotal cardiovascular outcome trials. The primary endpoint assessed was a composite of all-cause mortality, myocardial infarction, and stroke.

Findings showed no major difference between semaglutide and tirzepatide. When comparing tirzepatide to sitagliptin, there was a substantial risk reduction initiating tirzepatide.

Interview Questions:

1. What prompted this large-scale real-world analysis comparing GLP-1 receptor agonists and how does it complement existing cardiovascular outcome trial data?
2. Can you walk us through the study design and methodology?
3. What were the key findings?
4. How did the safety profiles compare?
5. What are the clinical implications of these findings for practice?
6. What are your key take-home messages for clinicians?
7. What are the next steps for this research program?

Visit our AHA 2025 Late-Breaking and Featured Science Collection page for more coverage.

Recorded on-site at AHA Scientific Sessions 2025, Chicago.

Editors: Jordan Rance.
Videographer: David Ben-Harosh, Dan Brent, Mike Knight.

Support: This is an independent interview produced by Radcliffe Cardiology.