Cardiorenal Outcomes With Tirzepatide Compared With Dulaglutide in Patients With Diabetes and Cardiovascular Disease: A Post Hoc Analysis of the SURPASS-CVOT Randomized Clinical Trial.

Nissen SE, Wolski K, D'Alessio D, Weerakkody G, Kiljanski J, Wiese RJ, Pavo I, Cariou B, Nicholls SJ

JAMA cardiology1 Jun 2026Cited by 6 (Europe PMC)

PMID41903177PMCIDPMC13033170DOI10.1001/jamacardio.2026.0767PepBankPUB-41903177

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Summary

The text of this summary is not shown here, because the article license does not allow reuse. Read it at the source (opens in a new tab)

Text rights: CC BY-NC-ND. Results still quote short attributed sentences.

Results from this study10

10 results from studies that gave the peptide. 10 results from people.

01HumanRandomized controlled trialEfficacy outcome
In patients with type 2 diabetes and cardiovascular disease, tirzepatide reduced the 6-component cardiorenal composite versus dulaglutide (HR 0.84; 23.7% versus 27.4%).
In plain wordsIn adults with diabetes and heart disease, tirzepatide led to fewer serious heart and kidney events than dulaglutide (23.7% versus 27.4%).
Peptide
Tirzepatide
Outcome
DecreaseSix-component cardiorenal composite
Study
n = 13,165
Comparator
Dulaglutide 1.5 mg
Analysis
Primary
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
up to 15 mg weekly · subcutaneous · median 46.9 monthsAs given in this study (human).
Measurements
HR
0.84 ratio
6-component composite vs dulaglutide
event rate
23.7%
tirzepatide
event rate
27.4%
dulaglutide
Source sentences
Summary
After a median (IQR) treatment duration of 46.9 (34.6-50.6) months, the primary cardiorenal end point occurred in 1559 tirzepatide-treated patients (23.7%) and 1803 dulaglutide-treated patients (27.4%; hazard ratio [HR], 0.84; 95% CI, 0.79-0.90; P < .001).
2 context sentences(design, population, supporting numbers)
Summary · context
This parallel-design double-blind trial enrolled patients with diabetes and preexisting cardiovascular disease (from May 29, 2020, to June 27, 2022) at 640 centers in North and South America, Europe, Asia, and Oceania.
Summary · context
Participants were randomized to receive subcutaneous tirzepatide up to 15 mg (n = 6586) or a fixed dose of dulaglutide, 1.5 mg (n = 6579), administered weekly.
Report a problemFND-4190317701
02HumanRandomized controlled trialEfficacy outcome
In patients with diabetes and cardiovascular disease, dulaglutide had more six-component cardiorenal events than tirzepatide.
In plain wordsIn patients with diabetes and heart disease, dulaglutide had more combined heart, kidney, or death events than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseSix-component cardiorenal composite
Study
n = 13,165
Comparator
Tirzepatide up to 15 mg
Analysis
Primary
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
1.5 mg weekly · subcutaneous · median treatment duration 46.9 monthsAs given in this study (human).
Measurements
patients with primary cardiorenal end point, dulaglutide
1803 patients
dulaglutide 1.5 mg
proportion with primary cardiorenal end point, dulaglutide
27.4%
dulaglutide 1.5 mg
patients with primary cardiorenal end point, tirzepatide
1559 patients
tirzepatide up to 15 mg
proportion with primary cardiorenal end point, tirzepatide
23.7%
tirzepatide up to 15 mg
hazard ratio, primary cardiorenal end point
0.84 HR
tirzepatide versus dulaglutide
95% CI of hazard ratio
0.79 to 0.9 HR
tirzepatide versus dulaglutide
Source sentences
Summary
After a median (IQR) treatment duration of 46.9 (34.6-50.6) months, the primary cardiorenal end point occurred in 1559 tirzepatide-treated patients (23.7%) and 1803 dulaglutide-treated patients (27.4%; hazard ratio [HR], 0.84; 95% CI, 0.79-0.90; P < .001).
2 context sentences(design, population, supporting numbers)
Summary · context
This parallel-design double-blind trial enrolled patients with diabetes and preexisting cardiovascular disease (from May 29, 2020, to June 27, 2022) at 640 centers in North and South America, Europe, Asia, and Oceania.
Summary · context
Participants were randomized to receive subcutaneous tirzepatide up to 15 mg (n = 6586) or a fixed dose of dulaglutide, 1.5 mg (n = 6579), administered weekly.
Report a problemFND-4190317706
03HumanRandomized controlled trialEfficacy outcome
In patients with type 2 diabetes and cardiovascular disease, a sensitivity analysis found that tirzepatide reduced the 5-component composite versus dulaglutide (HR 0.86).
In plain wordsIn adults with diabetes and heart disease, tirzepatide led to fewer heart events than dulaglutide in a check that left out kidney events.
Peptide
Tirzepatide
Outcome
DecreaseFive-component composite without kidney outcomes
Study
n = 13,165
Comparator
Dulaglutide 1.5 mg
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
up to 15 mg weekly · subcutaneous · median 46.9 monthsAs given in this study (human).
Measurements
HR
0.86 ratio
5-component composite vs dulaglutide
Source sentences
Summary
Sensitivity analyses showed similar hazard ratios for a narrower 5-component end point (without the kidney composite outcomes: HR, 0.86; 95% CI, 0.80-0.93) and the 4-component composite (without either kidney or heart failure end points: HR, 0.86; 95% CI, 0.80-0.93).
2 context sentences(design, population, supporting numbers)
Summary · context
This parallel-design double-blind trial enrolled patients with diabetes and preexisting cardiovascular disease (from May 29, 2020, to June 27, 2022) at 640 centers in North and South America, Europe, Asia, and Oceania.
Summary · context
Participants were randomized to receive subcutaneous tirzepatide up to 15 mg (n = 6586) or a fixed dose of dulaglutide, 1.5 mg (n = 6579), administered weekly.
Report a problemFND-4190317702
04HumanRandomized controlled trialEfficacy outcome
In patients with type 2 diabetes and cardiovascular disease, a sensitivity analysis found that tirzepatide reduced the 4-component composite versus dulaglutide (HR 0.86).
In plain wordsIn adults with diabetes and heart disease, tirzepatide led to fewer heart events than dulaglutide when kidney and heart failure events were left out.
Peptide
Tirzepatide
Outcome
DecreaseFour-component composite without kidney or heart failure outcomes
Study
n = 13,165
Comparator
Dulaglutide 1.5 mg
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
up to 15 mg weekly · subcutaneous · median 46.9 monthsAs given in this study (human).
Measurements
HR
0.86 ratio
4-component composite vs dulaglutide
Source sentences
Summary
Sensitivity analyses showed similar hazard ratios for a narrower 5-component end point (without the kidney composite outcomes: HR, 0.86; 95% CI, 0.80-0.93) and the 4-component composite (without either kidney or heart failure end points: HR, 0.86; 95% CI, 0.80-0.93).
2 context sentences(design, population, supporting numbers)
Summary · context
This parallel-design double-blind trial enrolled patients with diabetes and preexisting cardiovascular disease (from May 29, 2020, to June 27, 2022) at 640 centers in North and South America, Europe, Asia, and Oceania.
Summary · context
Participants were randomized to receive subcutaneous tirzepatide up to 15 mg (n = 6586) or a fixed dose of dulaglutide, 1.5 mg (n = 6579), administered weekly.
Report a problemFND-4190317703
05HumanRandomized controlled trialSafety outcome
In patients with type 2 diabetes and cardiovascular disease, gastrointestinal adverse events were more common with tirzepatide (42.5%) than with dulaglutide (35.9%).
In plain wordsIn adults with diabetes and heart disease, tirzepatide caused more digestive side effects than dulaglutide (42.5% versus 35.9%).
Peptide
Tirzepatide
Outcome
IncreaseGastrointestinal adverse events
Study
n = 13,165
Comparator
Dulaglutide 1.5 mg
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
up to 15 mg weekly · subcutaneous · median 46.9 monthsAs given in this study (human).
Measurements
GI adverse events
42.5%
tirzepatide
GI adverse events
35.9%
dulaglutide
Source sentences
Summary
Gastrointestinal adverse events were more common with tirzepatide (2827 patients [42.5%]) than dulaglutide (2387 patients [35.9%]) treatment.
2 context sentences(design, population, supporting numbers)
Summary · context
This parallel-design double-blind trial enrolled patients with diabetes and preexisting cardiovascular disease (from May 29, 2020, to June 27, 2022) at 640 centers in North and South America, Europe, Asia, and Oceania.
Summary · context
Participants were randomized to receive subcutaneous tirzepatide up to 15 mg (n = 6586) or a fixed dose of dulaglutide, 1.5 mg (n = 6579), administered weekly.
Report a problemFND-4190317704
06HumanRandomized controlled trialSafety outcome
In patients with type 2 diabetes and cardiovascular disease, adverse events other than gastrointestinal ones were similar between tirzepatide and dulaglutide.
In plain wordsIn adults with diabetes and heart disease, other side effects were similar for tirzepatide and dulaglutide.
Peptide
Tirzepatide
Outcome
No significant changeOther adverse events
Study
n = 13,165
Comparator
Dulaglutide 1.5 mg
Outcome group
Adverse events · Whole body
Studied dose
up to 15 mg weekly · subcutaneous · median 46.9 monthsAs given in this study (human).
Source sentences
Summary
Other adverse events were similar.
2 context sentences(design, population, supporting numbers)
Summary · context
This parallel-design double-blind trial enrolled patients with diabetes and preexisting cardiovascular disease (from May 29, 2020, to June 27, 2022) at 640 centers in North and South America, Europe, Asia, and Oceania.
Summary · context
Participants were randomized to receive subcutaneous tirzepatide up to 15 mg (n = 6586) or a fixed dose of dulaglutide, 1.5 mg (n = 6579), administered weekly.
Report a problemFND-4190317705
07HumanRandomized controlled trialEfficacy outcome
In patients with diabetes and cardiovascular disease, the five-component event hazard was higher with dulaglutide than tirzepatide.
In plain wordsIn patients with diabetes and heart disease, the five-component event risk was higher with dulaglutide than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseFive-component composite
Study
n = 13,165
Comparator
Tirzepatide up to 15 mg
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
1.5 mg weekly · subcutaneous · median treatment duration 46.9 monthsAs given in this study (human).
Measurements
hazard ratio, 5-component end point
0.86 HR
tirzepatide versus dulaglutide
95% CI of hazard ratio
0.8 to 0.93 HR
tirzepatide versus dulaglutide
Source sentences
Summary
Sensitivity analyses showed similar hazard ratios for a narrower 5-component end point (without the kidney composite outcomes: HR, 0.86; 95% CI, 0.80-0.93) and the 4-component composite (without either kidney or heart failure end points: HR, 0.86; 95% CI, 0.80-0.93).
2 context sentences(design, population, supporting numbers)
Summary · context
This parallel-design double-blind trial enrolled patients with diabetes and preexisting cardiovascular disease (from May 29, 2020, to June 27, 2022) at 640 centers in North and South America, Europe, Asia, and Oceania.
Summary · context
Participants were randomized to receive subcutaneous tirzepatide up to 15 mg (n = 6586) or a fixed dose of dulaglutide, 1.5 mg (n = 6579), administered weekly.
Report a problemFND-4190317707
08HumanRandomized controlled trialEfficacy outcome
In patients with diabetes and cardiovascular disease, the four-component event hazard was higher with dulaglutide than tirzepatide.
In plain wordsIn patients with diabetes and heart disease, the four-component event risk was higher with dulaglutide than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
IncreaseFour-component composite
Study
n = 13,165
Comparator
Tirzepatide up to 15 mg
Outcome group
Cardiovascular events · Cardiovascular
Studied dose
1.5 mg weekly · subcutaneous · median treatment duration 46.9 monthsAs given in this study (human).
Measurements
hazard ratio, 4-component end point
0.86 HR
tirzepatide versus dulaglutide
95% CI of hazard ratio
0.8 to 0.93 HR
tirzepatide versus dulaglutide
Source sentences
Summary
Sensitivity analyses showed similar hazard ratios for a narrower 5-component end point (without the kidney composite outcomes: HR, 0.86; 95% CI, 0.80-0.93) and the 4-component composite (without either kidney or heart failure end points: HR, 0.86; 95% CI, 0.80-0.93).
2 context sentences(design, population, supporting numbers)
Summary · context
This parallel-design double-blind trial enrolled patients with diabetes and preexisting cardiovascular disease (from May 29, 2020, to June 27, 2022) at 640 centers in North and South America, Europe, Asia, and Oceania.
Summary · context
Participants were randomized to receive subcutaneous tirzepatide up to 15 mg (n = 6586) or a fixed dose of dulaglutide, 1.5 mg (n = 6579), administered weekly.
Report a problemFND-4190317708
09HumanRandomized controlled trialSafety outcome
In patients with diabetes and cardiovascular disease, gastrointestinal adverse events were less common with dulaglutide than tirzepatide.
In plain wordsIn patients with diabetes and heart disease, dulaglutide caused fewer digestive side effects than tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
DecreaseGastrointestinal adverse events
Study
n = 13,165
Comparator
Tirzepatide up to 15 mg
Outcome group
Gastrointestinal adverse events · Gastrointestinal
Studied dose
1.5 mg weekly · subcutaneous · median treatment duration 46.9 monthsAs given in this study (human).
Measurements
patients with gastrointestinal adverse events, dulaglutide
2387 patients
dulaglutide 1.5 mg
proportion with gastrointestinal adverse events, dulaglutide
35.9%
dulaglutide 1.5 mg
patients with gastrointestinal adverse events, tirzepatide
2827 patients
tirzepatide up to 15 mg
proportion with gastrointestinal adverse events, tirzepatide
42.5%
tirzepatide up to 15 mg
Source sentences
Summary
Gastrointestinal adverse events were more common with tirzepatide (2827 patients [42.5%]) than dulaglutide (2387 patients [35.9%]) treatment.
2 context sentences(design, population, supporting numbers)
Summary · context
This parallel-design double-blind trial enrolled patients with diabetes and preexisting cardiovascular disease (from May 29, 2020, to June 27, 2022) at 640 centers in North and South America, Europe, Asia, and Oceania.
Summary · context
Participants were randomized to receive subcutaneous tirzepatide up to 15 mg (n = 6586) or a fixed dose of dulaglutide, 1.5 mg (n = 6579), administered weekly.
Report a problemFND-4190317709
10HumanRandomized controlled trialSafety outcome
In patients with diabetes and cardiovascular disease, other adverse events were similar with dulaglutide and tirzepatide.
In plain wordsIn patients with diabetes and heart disease, other side effects were similar with dulaglutide and tirzepatide.
Peptide
Dulaglutide (Trulicity)
Outcome
No significant changeOther adverse events
Study
n = 13,165
Comparator
Tirzepatide up to 15 mg
Outcome group
Adverse events · Whole body
Studied dose
1.5 mg weekly · subcutaneous · median treatment duration 46.9 monthsAs given in this study (human).
Source sentences
Summary
Other adverse events were similar.
2 context sentences(design, population, supporting numbers)
Summary · context
This parallel-design double-blind trial enrolled patients with diabetes and preexisting cardiovascular disease (from May 29, 2020, to June 27, 2022) at 640 centers in North and South America, Europe, Asia, and Oceania.
Summary · context
Participants were randomized to receive subcutaneous tirzepatide up to 15 mg (n = 6586) or a fixed dose of dulaglutide, 1.5 mg (n = 6579), administered weekly.
Report a problemFND-4190317710

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

Registered trials1

Trials this study reports on, or that list this study as a reference. Registry data from ClinicalTrials.gov.

1 trial · 1 completed · 1 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 3Results postedNCT04255433

A Study of Tirzepatide (LY3298176) Compared With Dulaglutide on Major Cardiovascular Events in Participants With Type 2 Diabetes

Eli Lilly and Companyn = 13,29929 May 2020 to 12 Jun 2025

Type 2 Diabetes Mellitus

Trial page ClinicalTrials.govUpdated 8 Jul 2026

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.

Versions 4 to 8Current
28 Oct 2026, 02:03 UTC
The same notice was added 5 times, first on 22 Oct 2026, 02:26 UTC. The status did not change between them.
Study results updated
Version 3
21 Oct 2026, 18:59 UTC
Study data updated · source update from Europe PMC
Version 2
12 Oct 2026, 12:10 UTC
Study results updated
Version 1
9 Oct 2026, 03:07 UTC
First added · source update from Europe PMC