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Real-World Study Finds Semaglutide and Tirzepatide Cut Cardiovascular Risk in Type 2 Diabetes

A Nature Medicine analysis of nearly one million U.S. insurance records reports measurable cardiovascular risk reductions in routine care.

The study involved Novo Nordisk’s semaglutide 2.4mg. Credit: Kittyfly / Shutterstock.com.
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Overview

  • In routine-care cohorts, semaglutide reduced stroke and heart attack by 18% versus sitagliptin over about one year.
  • Tirzepatide lowered the combined risk of stroke, heart attack, and death by 13% compared with dulaglutide.
  • A head-to-head comparison showed no meaningful difference between tirzepatide and semaglutide for major cardiovascular outcomes (HR 1.06; 95% CI 0.95–1.18).
  • Researchers emulated randomized trials using Medicare, Optum, and MarketScan claims databases, reported early benefits not fully explained by weight loss, and presented the findings at AHA 2025.
  • A separate AHA presentation in heart-failure patients without diabetes found semaglutide 2.4 mg was associated with large reductions in MACE and heart-failure events, with caution urged given the observational design.