Skip to content

Study · Observational study · n = 17,912 · 2026

5 results

Comparative effectiveness of tirzepatide and DPP-4 inhibitors in type 2 diabetes with heart failure.

Mortada I, Paul K, Chammany M, Abraham Y, Devulapally K, Lee AW, Mansour S, Chatila K, Boyars MC, Jehle D, Blackwell TA, Jneid H

Diabetes & vascular disease research8 Jul 2026

PMID42420805 (opens in a new tab)PMCIDPMC13346706 (opens in a new tab)DOI10.1177/14791641261467888 (opens in a new tab)PepBankPUB-42420805
Download PDFPubMedAsk about this study
Jump to 5 results

Summary

While patients with type 2 diabetes mellitus (T2DM) and heart failure (HF) are frequently prescribed dipeptidyl peptidase-4 inhibitors (DPP-4is), emerging evidence suggests glucagon-like peptide-1 receptor agonists may offer improved outcomes. This study compared the effectiveness of tirzepatide versus DPP-4i in patients with T2DM and HF. Adults with T2DM and HF treated between 2022 and 2025 were included. Cohort A comprised patients receiving tirzepatide, and Cohort B comprised patients receiving DPP-4is. Prespecified subgroup analyses were conducted for HF with reduced ejection fraction (HFrEF) and HF with non-reduced ejection fraction (HFnonrEF). Propensity score matching was performed across demographic, clinical, medication, and laboratory covariates. Outcomes included all-cause mortality, hospitalization, HF exacerbation, and major adverse cardiovascular events (MACE). After matching, 8,956 patients were included in each group. Tirzepatide therapy was associated with a lower hazard of all-cause mortality (HR 0.32, 95% CI 0.25-0.42), hospitalizations (HR 0.53, 95% CI 0.48-0.57), HF exacerbation (HR 0.37, 95% CI 0.33-0.42) and MACE (HR 0.79, 95% CI 0.73-0.84). Sub-group analyses for HFrEF and HFnonrEF demonstrated similar trends. In conclusion, among patients with T2DM and HF, treatment with tirzepatide was associated with markedly lower hazards of mortality, hospitalization, HF exacerbation, and MACE compared to DPP-4 inhibitors.
CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study5

5 results from studies that gave the peptide. 5 results from people.

  1. 01HumanObservational studyEfficacy outcome

    In adults with type 2 diabetes and heart failure, tirzepatide was associated with a lower hazard of all-cause mortality than DPP-4 inhibitors.

    In plain wordsIn adults with type 2 diabetes and heart failure, tirzepatide was linked to fewer deaths than DPP-4 inhibitors.

    Peptide
    Tirzepatide
    Outcome
    DecreaseAll-cause mortality
    Study

    n = 17,912

    Comparator
    DPP-4 inhibitors
    Outcome group
    Mortality · Cardiovascular
    Studied dose
    Dose not stated

    Measurements

    HR
    0.32 ratio
    all-cause mortality

    Source sentences

    Summary
    Tirzepatide therapy was associated with a lower hazard of all-cause mortality (HR 0.32, 95% CI 0.25-0.42)
    2 context sentences
    Summary · context
    Adults with T2DM and HF treated between 2022 and 2025 were included.
    Summary · context
    After matching, 8,956 patients were included in each group.
  2. 02HumanObservational studyEfficacy outcome

    In adults with type 2 diabetes and heart failure, tirzepatide was associated with a lower hazard of hospitalization than DPP-4 inhibitors.

    In plain wordsIn adults with type 2 diabetes and heart failure, tirzepatide was linked to fewer hospital stays than DPP-4 inhibitors.

    Peptide
    Tirzepatide
    Outcome
    DecreaseHospitalization
    Study

    n = 17,912

    Comparator
    DPP-4 inhibitors
    Outcome group
    Cardiovascular events · Cardiovascular
    Studied dose
    Dose not stated

    Measurements

    HR
    0.53 ratio
    hospitalizations

    Source sentences

    Summary
    Tirzepatide therapy was associated with a lower hazard of all-cause mortality (HR 0.32, 95% CI 0.25-0.42), hospitalizations (HR 0.53, 95% CI 0.48-0.57)
    2 context sentences
    Summary · context
    Adults with T2DM and HF treated between 2022 and 2025 were included.
    Summary · context
    After matching, 8,956 patients were included in each group.
  3. 03HumanObservational studyEfficacy outcome

    In adults with type 2 diabetes and heart failure, tirzepatide was associated with a lower hazard of heart failure exacerbation than DPP-4 inhibitors.

    In plain wordsIn adults with type 2 diabetes and heart failure, tirzepatide was linked to fewer heart failure flare-ups than DPP-4 inhibitors.

    Peptide
    Tirzepatide
    Outcome
    DecreaseHeart failure exacerbation
    Study

    n = 17,912

    Comparator
    DPP-4 inhibitors
    Outcome group
    Heart function · Cardiovascular
    Studied dose
    Dose not stated

    Measurements

    HR
    0.37 ratio
    HF exacerbation

    Source sentences

    Summary
    Tirzepatide therapy was associated with a lower hazard of all-cause mortality (HR 0.32, 95% CI 0.25-0.42), hospitalizations (HR 0.53, 95% CI 0.48-0.57), HF exacerbation (HR 0.37, 95% CI 0.33-0.42)
    2 context sentences
    Summary · context
    Adults with T2DM and HF treated between 2022 and 2025 were included.
    Summary · context
    After matching, 8,956 patients were included in each group.
  4. 04HumanObservational studyEfficacy outcome

    In adults with type 2 diabetes and heart failure, tirzepatide was associated with a lower hazard of MACE than DPP-4 inhibitors.

    In plain wordsIn adults with type 2 diabetes and heart failure, tirzepatide was linked to fewer serious heart events than DPP-4 inhibitors.

    Peptide
    Tirzepatide
    Outcome
    DecreaseMajor adverse cardiovascular events (MACE)
    Study

    n = 17,912

    Comparator
    DPP-4 inhibitors
    Outcome group
    Cardiovascular events · Cardiovascular
    Studied dose
    Dose not stated

    Measurements

    HR
    0.79 ratio
    MACE

    Source sentences

    Summary
    Tirzepatide therapy was associated with a lower hazard of all-cause mortality (HR 0.32, 95% CI 0.25-0.42), hospitalizations (HR 0.53, 95% CI 0.48-0.57), HF exacerbation (HR 0.37, 95% CI 0.33-0.42) and MACE (HR 0.79, 95% CI 0.73-0.84).
    2 context sentences
    Summary · context
    Adults with T2DM and HF treated between 2022 and 2025 were included.
    Summary · context
    After matching, 8,956 patients were included in each group.
  5. 05HumanObservational studyEfficacy outcome

    In prespecified subgroups with reduced or non-reduced ejection fraction heart failure, tirzepatide showed similar trends of lower hazards than DPP-4 inhibitors.

    In plain wordsIn adults with type 2 diabetes and either type of heart failure, tirzepatide showed similar benefit trends compared with DPP-4 inhibitors.

    Peptide
    Tirzepatide
    Outcome
    DecreaseOutcomes in HFrEF and HFnonrEF subgroups
    Study

    n: not reported in source

    Comparator
    DPP-4 inhibitors
    Outcome group
    Cardiovascular events · Cardiovascular
    Studied dose
    Dose not stated

    Source sentences

    Summary
    Sub-group analyses for HFrEF and HFnonrEF demonstrated similar trends.
    2 context sentences
    Summary · context
    Adults with T2DM and HF treated between 2022 and 2025 were included.
    Summary · context
    After matching, 8,956 patients were included in each group.

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 2Current

    12 Oct 2026, 12:10 UTC

    Study results updated

  2. Version 1

    9 Oct 2026, 03:07 UTC

    First added · source update from Europe PMC

Subjects

Terms as the source lists them.

PepBank is a research reference. Talk to a doctor before you use any peptide.