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Study · Observational study · n = 1,258 · 2026

8 results

Semaglutide vs tirzepatide in patients with obesity and HFpEF: a report from a global federated research network.

Monzo L, Savarese G, Duarte K, Baudry G, Petrie MC, Girerd N

ESC heart failure1 Feb 2026Cited by 3 (Europe PMC)

PMID41711744 (opens in a new tab)PMCIDPMC13108322 (opens in a new tab)DOI10.1093/eschf/xvag042 (opens in a new tab)PepBankPUB-41711744
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Summary

Background and aimsSemaglutide and tirzepatide have been shown to reduce body weight, improve health status, and lower rates of clinical events in patients with obesity and heart failure with preserved ejection fraction (HFpEF). Although recent data suggest that tirzepatide leads to greater weight loss compared to semaglutide in non-HF populations, it remains uncertain whether these different drugs might result in different clinical event rates. This study aims to compare the rates of clinical outcomes for semaglutide vs tirzepatide in patients with obesity and HFpEF.MethodsIn this non-randomized, observational cohort study, adults with obesity and a concurrent diagnosis of HFpEF who initiated treatment with semaglutide or tirzepatide for the first time between November 2023 and May 2025 were identified using electronic health record data from the TriNetX Global Collaborative Research Network. The primary endpoint was a composite of all-cause mortality and HF hospitalization, evaluated after propensity score matching (PSM).ResultsAmong 3983 patients meeting the study criteria (semaglutide, 2719; tirzepatide, 1264), 1258 remained in each group after PSM (mean age 66 years, 41% male, 77% White, mean body mass index 42 kg/m², 63% with diabetes). Over a median follow-up of 24 weeks, semaglutide and tirzepatide were associated with a similar risk of the primary composite endpoint (HR 1.14 [95% CI, 0.89-1.46]; P = .286), and of its individual components (all-cause death: HR 1.24 [95% CI, 0.63-2.44]; P = .531; HF hospitalization: HR 1.10 [95% CI, 0.85-1.43]; P = .471), irrespective of diabetes status.ConclusionsIn this real-world analysis, no difference was observed between semaglutide and tirzepatide in terms of clinical outcomes among patients with obesity and HFpEF.
CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study8

8 results from studies that gave the peptide. 8 results from people.

  1. 01HumanObservational studyEfficacy outcome

    In adults with obesity and HFpEF, semaglutide and tirzepatide were associated with a similar risk of the composite of all-cause death and HF hospitalization (HR 1.14, 95% CI 0.89-1.46; P = .286).

    In plain wordsIn adults with obesity and heart failure, semaglutide and tirzepatide were linked to a similar risk of death or hospital stay for heart failure.

    Peptide
    Semaglutide
    Outcome
    No significant changeComposite of all-cause mortality and HF hospitalization
    Study

    n = 1,258

    Comparator
    Tirzepatide
    Analysis
    Primary
    Outcome group
    Cardiovascular events · Cardiovascular
    Studied dose
    Dose not stated

    Measurements

    HR
    1.14 ratio
    semaglutide versus tirzepatide

    Source sentences

    Summary
    semaglutide and tirzepatide were associated with a similar risk of the primary composite endpoint (HR 1.14 [95% CI, 0.89-1.46]; P = .286
    2 context sentences
    Summary · context
    In this non-randomized, observational cohort study, adults with obesity and a concurrent diagnosis of HFpEF who initiated treatment with semaglutide or tirzepatide for the first time between November 2023 and May 2025 were identified using electronic health record data from the TriNetX Global Collaborative Research Network.
    Summary · context
    Among 3983 patients meeting the study criteria (semaglutide, 2719; tirzepatide, 1264), 1258 remained in each group after PSM (mean age 66 years, 41% male, 77% White, mean body mass index 42 kg/m², 63% with diabetes).
  2. 02HumanObservational studyEfficacy outcome

    In adults with obesity and HFpEF, tirzepatide and semaglutide were associated with a similar risk of the composite of all-cause death and HF hospitalization (HR 1.14, 95% CI 0.89-1.46; P = .286).

    In plain wordsIn adults with obesity and heart failure, tirzepatide and semaglutide were linked to a similar risk of death or hospital stay for heart failure.

    Peptide
    Tirzepatide
    Outcome
    No significant changeComposite of all-cause mortality and HF hospitalization
    Study

    n = 1,258

    Comparator
    Semaglutide
    Analysis
    Primary
    Outcome group
    Cardiovascular events · Cardiovascular
    Studied dose
    Dose not stated

    Measurements

    HR
    1.14 ratio
    semaglutide versus tirzepatide

    Source sentences

    Summary
    semaglutide and tirzepatide were associated with a similar risk of the primary composite endpoint (HR 1.14 [95% CI, 0.89-1.46]; P = .286
    2 context sentences
    Summary · context
    In this non-randomized, observational cohort study, adults with obesity and a concurrent diagnosis of HFpEF who initiated treatment with semaglutide or tirzepatide for the first time between November 2023 and May 2025 were identified using electronic health record data from the TriNetX Global Collaborative Research Network.
    Summary · context
    Among 3983 patients meeting the study criteria (semaglutide, 2719; tirzepatide, 1264), 1258 remained in each group after PSM (mean age 66 years, 41% male, 77% White, mean body mass index 42 kg/m², 63% with diabetes).
  3. 03HumanObservational studyEfficacy outcome

    In adults with obesity and HFpEF, semaglutide was associated with a similar risk of all-cause death as tirzepatide (HR 1.24, 95% CI 0.63-2.44; P = .531).

    In plain wordsIn adults with obesity and heart failure, semaglutide was linked to a similar risk of death as tirzepatide.

    Peptide
    Semaglutide
    Outcome
    No significant changeAll-cause death
    Study

    n = 1,258

    Comparator
    Tirzepatide
    Outcome group
    Mortality · Cardiovascular
    Studied dose
    Dose not stated

    Measurements

    HR
    1.24 ratio
    semaglutide versus tirzepatide

    Source sentences

    Summary
    all-cause death: HR 1.24 [95% CI, 0.63-2.44]; P = .531
    2 context sentences
    Summary · context
    In this non-randomized, observational cohort study, adults with obesity and a concurrent diagnosis of HFpEF who initiated treatment with semaglutide or tirzepatide for the first time between November 2023 and May 2025 were identified using electronic health record data from the TriNetX Global Collaborative Research Network.
    Summary · context
    Among 3983 patients meeting the study criteria (semaglutide, 2719; tirzepatide, 1264), 1258 remained in each group after PSM (mean age 66 years, 41% male, 77% White, mean body mass index 42 kg/m², 63% with diabetes).
  4. 04HumanObservational studyEfficacy outcome

    In adults with obesity and HFpEF, tirzepatide was associated with a similar risk of all-cause death as semaglutide (HR 1.24, 95% CI 0.63-2.44; P = .531).

    In plain wordsIn adults with obesity and heart failure, tirzepatide was linked to a similar risk of death as semaglutide.

    Peptide
    Tirzepatide
    Outcome
    No significant changeAll-cause death
    Study

    n = 1,258

    Comparator
    Semaglutide
    Outcome group
    Mortality · Cardiovascular
    Studied dose
    Dose not stated

    Measurements

    HR
    1.24 ratio
    semaglutide versus tirzepatide

    Source sentences

    Summary
    all-cause death: HR 1.24 [95% CI, 0.63-2.44]; P = .531
    2 context sentences
    Summary · context
    In this non-randomized, observational cohort study, adults with obesity and a concurrent diagnosis of HFpEF who initiated treatment with semaglutide or tirzepatide for the first time between November 2023 and May 2025 were identified using electronic health record data from the TriNetX Global Collaborative Research Network.
    Summary · context
    Among 3983 patients meeting the study criteria (semaglutide, 2719; tirzepatide, 1264), 1258 remained in each group after PSM (mean age 66 years, 41% male, 77% White, mean body mass index 42 kg/m², 63% with diabetes).
  5. 05HumanObservational studyEfficacy outcome

    In adults with obesity and HFpEF, semaglutide was associated with a similar risk of HF hospitalization as tirzepatide (HR 1.10, 95% CI 0.85-1.43; P = .471).

    In plain wordsIn adults with obesity and heart failure, semaglutide was linked to a similar risk of hospital stay for heart failure as tirzepatide.

    Peptide
    Semaglutide
    Outcome
    No significant changeHF hospitalization
    Study

    n = 1,258

    Comparator
    Tirzepatide
    Outcome group
    Cardiovascular events · Cardiovascular
    Studied dose
    Dose not stated

    Measurements

    HR
    1.1 ratio
    semaglutide versus tirzepatide

    Source sentences

    Summary
    HF hospitalization: HR 1.10 [95% CI, 0.85-1.43]; P = .471
    2 context sentences
    Summary · context
    In this non-randomized, observational cohort study, adults with obesity and a concurrent diagnosis of HFpEF who initiated treatment with semaglutide or tirzepatide for the first time between November 2023 and May 2025 were identified using electronic health record data from the TriNetX Global Collaborative Research Network.
    Summary · context
    Among 3983 patients meeting the study criteria (semaglutide, 2719; tirzepatide, 1264), 1258 remained in each group after PSM (mean age 66 years, 41% male, 77% White, mean body mass index 42 kg/m², 63% with diabetes).
  6. 06HumanObservational studyEfficacy outcome

    In adults with obesity and HFpEF, tirzepatide was associated with a similar risk of HF hospitalization as semaglutide (HR 1.10, 95% CI 0.85-1.43; P = .471).

    In plain wordsIn adults with obesity and heart failure, tirzepatide was linked to a similar risk of hospital stay for heart failure as semaglutide.

    Peptide
    Tirzepatide
    Outcome
    No significant changeHF hospitalization
    Study

    n = 1,258

    Comparator
    Semaglutide
    Outcome group
    Cardiovascular events · Cardiovascular
    Studied dose
    Dose not stated

    Measurements

    HR
    1.1 ratio
    semaglutide versus tirzepatide

    Source sentences

    Summary
    HF hospitalization: HR 1.10 [95% CI, 0.85-1.43]; P = .471
    2 context sentences
    Summary · context
    In this non-randomized, observational cohort study, adults with obesity and a concurrent diagnosis of HFpEF who initiated treatment with semaglutide or tirzepatide for the first time between November 2023 and May 2025 were identified using electronic health record data from the TriNetX Global Collaborative Research Network.
    Summary · context
    Among 3983 patients meeting the study criteria (semaglutide, 2719; tirzepatide, 1264), 1258 remained in each group after PSM (mean age 66 years, 41% male, 77% White, mean body mass index 42 kg/m², 63% with diabetes).
  7. 07HumanObservational studyEfficacy outcome

    In adults with obesity and HFpEF, semaglutide and tirzepatide were associated with similar risk of clinical outcomes irrespective of diabetes status.

    In plain wordsIn adults with obesity and heart failure, semaglutide and tirzepatide were linked to similar outcomes whether or not people had diabetes.

    Peptide
    Semaglutide
    Outcome
    No significant changeClinical outcomes irrespective of diabetes status
    Study

    n = 1,258

    Comparator
    Tirzepatide
    Outcome group
    Cardiovascular events · Cardiovascular
    Studied dose
    Dose not stated

    Source sentences

    Summary
    irrespective of diabetes status.
    2 context sentences
    Summary · context
    In this non-randomized, observational cohort study, adults with obesity and a concurrent diagnosis of HFpEF who initiated treatment with semaglutide or tirzepatide for the first time between November 2023 and May 2025 were identified using electronic health record data from the TriNetX Global Collaborative Research Network.
    Summary · context
    Among 3983 patients meeting the study criteria (semaglutide, 2719; tirzepatide, 1264), 1258 remained in each group after PSM (mean age 66 years, 41% male, 77% White, mean body mass index 42 kg/m², 63% with diabetes).
  8. 08HumanObservational studyEfficacy outcome

    In adults with obesity and HFpEF, tirzepatide and semaglutide were associated with similar risk of clinical outcomes irrespective of diabetes status.

    In plain wordsIn adults with obesity and heart failure, tirzepatide and semaglutide were linked to similar outcomes whether or not people had diabetes.

    Peptide
    Tirzepatide
    Outcome
    No significant changeClinical outcomes irrespective of diabetes status
    Study

    n = 1,258

    Comparator
    Semaglutide
    Outcome group
    Cardiovascular events · Cardiovascular
    Studied dose
    Dose not stated

    Source sentences

    Summary
    irrespective of diabetes status.
    2 context sentences
    Summary · context
    In this non-randomized, observational cohort study, adults with obesity and a concurrent diagnosis of HFpEF who initiated treatment with semaglutide or tirzepatide for the first time between November 2023 and May 2025 were identified using electronic health record data from the TriNetX Global Collaborative Research Network.
    Summary · context
    Among 3983 patients meeting the study criteria (semaglutide, 2719; tirzepatide, 1264), 1258 remained in each group after PSM (mean age 66 years, 41% male, 77% White, mean body mass index 42 kg/m², 63% with diabetes).

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

  1. Version 3Current

    11 Oct 2026, 00:04 UTC

    Study results updated

  2. Version 2

    9 Oct 2026, 03:07 UTC

    Study data updated · source update from Europe PMC

  3. Version 1

    9 Oct 2026, 03:06 UTC

    First added · source update from Europe PMC

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Terms as the source lists them.

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