Semaglutide significantly reduced the risk of major adverse cardiovascular events (RR 0.71), whereas the reduction with tirzepatide did not reach statistical significance (RR 0.79).
Meta-Analysis (n=59,352)
Yes
Do semaglutide and tirzepatide reduce major adverse cardiovascular events in adults with type 2 diabetes mellitus, overweight or obesity?
Semaglutide demonstrates a consistent reduction in major adverse cardiovascular events in adults with T2DM or obesity, whereas evidence for tirzepatide remains limited and uncertain.
Relative Risk: 0.71 (95% CI 0.6–0.84)
p-value: p=<0.001
To systematically evaluate cardiovascular outcomes associated with semaglutide and tirzepatide in adults with type 2 diabetes mellitus (T2DM), overweight or obesity. We systematically searched PubMed, Embase, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.gov from inception to November 02, 2024, using standardized search terms for semaglutide and tirzepatide. The review was registered in PROSPERO (CRD420251008819). 47 randomized controlled trials (RCTs) involving 59,352 participants were included. Semaglutide was associated with a reduced risk of major adverse cardiovascular events (MACE) (RR, 0.71; 95% CI 0.60–0.84; p < 0.001), with reductions in cardiovascular death (RR, 0.81; 95% CI 0.72–0.93; p = 0.002), myocardial infarction (RR, 0.70; 95% CI 0.61–0.80; p < 0.001), and heart failure (RR, 0.60; 95% CI 0.41–0.87; p = 0.007), but not stroke (RR, 0.86; 95% CI 0.73-1.00; p = 0.056). For tirzepatide, a lower risk of myocardial infarction was observed (RR, 0.63; 95% CI 0.40-1.00; p = 0.049), whereas the reduction in MACE did not reach statistical significance (RR, 0.79; 95% CI 0.54–1.17; p = 0.245). Associations with cardiovascular death, heart failure, and stroke were also not statistically significant. Exploratory subgroup analyses suggested variation by treatment duration. Exploratory subgroup analyses suggested variation by treatment duration. Semaglutide showed a more consistent signal of cardiovascular benefit across the included trials, whereas cardiovascular outcome evidence for tirzepatide remained limited and uncertain. Because most available data were derived from separate drug-versus-control trials, the findings should not be interpreted as definitive comparative evidence favoring one agent over the other.
Xiao-yu et al. (Thu,) conducted a meta-analysis in Type 2 diabetes mellitus, overweight, or obesity (n=59,352). Semaglutide and Tirzepatide vs. Placebo or active comparators was evaluated on Major adverse cardiovascular events (MACE) (RR 0.71, 95% CI 0.60-0.84, p=<0.001). Semaglutide significantly reduced the risk of major adverse cardiovascular events (RR 0.71), whereas the reduction with tirzepatide did not reach statistical significance (RR 0.79).