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Real-World Study Finds Semaglutide and Tirzepatide Cut Heart Risks in Type 2 Diabetes

A Nature Medicine analysis of nearly one million U.S. patients using claims data reports early, trial-consistent cardiovascular risk reductions with these GLP-1 therapies.

Overview

  • The peer-reviewed study, published in Nature Medicine with results also presented at AHA Scientific Sessions 2025, analyzed Medicare, Optum Clinformatics, and Merative MarketScan claims covering routine U.S. care.
  • Semaglutide lowered one-year risk of myocardial infarction or stroke versus sitagliptin, showing an approximately 18% relative reduction (HR 0.82; 95% CI, 0.74–0.91).
  • Tirzepatide demonstrated cardiovascular effectiveness versus dulaglutide with a lower major adverse cardiovascular event rate (HR 0.87; 95% CI, 0.75–1.01).
  • In a head-to-head comparison, tirzepatide and semaglutide produced equivalent cardiovascular outcomes (HR 1.06; 95% CI, 0.95–1.18), indicating no clear advantage for either agent.
  • Trial-emulation benchmarks aligned closely with randomized data, benefits appeared early and likely extend beyond weight loss, and investigators cautioned about residual confounding for all-cause mortality in claims-based analyses.