Effects of tirzepatide on circulatory overload and end-organ damage in heart failure with preserved ejection fraction and obesity: a secondary analysis of the SUMMIT trial

Figures

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  Fig. 1. Effects of tirzepatide on pressure overload and volume expansion. a, Least-squares mean changes from baseline in systolic BP (SBP) plotted as a function of duration of treatment in participants randomized to tirzepatide (red circles) or placebo (black squares). b, The estimated mean treatment difference in the change in BV versus baseline with tirzepatide (TZP) compared with placebo plotted as a function of duration of treatment. The error bars represent s.e.m. for both panels; two-sided P < 0.001 for each time point comparison for a and b based upon comparing the least-squares means calculated from a mixed-model repeated-measures model incorporating baseline value, sex, history of HF decompensation within 12 months, diabetes status, baseline BMI group (<35, ≥35 kg m−2), treatment assignment, time, and treatment × time interaction. No correction was made for multiple hypothesis testing.

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  Fig. 2. Effects of tirzepatide on systemic inflammation, cardiac injury and natriuretic peptide levels. a, Least-squares mean changes from baseline in CRP plotted as a function of duration of treatment in participants randomized to tirzepatide (red circles) or placebo (black squares). b, The estimated mean treatment difference in the change in troponin T and NT-proBNP with tirzepatide (TZP) to baseline compared with placebo plotted as a function of duration of treatment. The error bars represent the s.e.m. for all panels; P values are two-sided for each time point comparison for a and b based upon comparing the least-squares means calculated from a mixed-model repeated-measures model incorporating baseline value, history of HF decompensation within 12 months, diabetes status, baseline BMI group (<35, ≥35 kg m−2), treatment assignment, time, and treatment × time interaction. No correction was made for multiple hypothesis testing.

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  Fig. 3. Effects of tirzepatide on kidney function and albuminuria. a, Top: least-squares mean changes from baseline in eGFR plotted as a function of duration of treatment in participants randomized to tirzepatide (red circles) or placebo (black squares). Bottom: the estimated mean treatment difference in the change in eGFR with tirzepatide versus baseline compared with placebo plotted as a function of duration of treatment. b, The least-squares mean change in UACR in participants treated with tirzepatide (red) and placebo (black) as a function of duration of treatment. The error bars represent the s.e.m. for all panels; P values are two-sided for each time point comparison for a and b based upon comparing the least-squares means calculated from a mixed-model repeated-measures model incorporating baseline value, sex, history of HF decompensation within 12 months, diabetes status, baseline BMI group (<35, ≥35 kg m−2), treatment assignment, time, and treatment × time interaction. No correction was made for multiple hypothesis testing.