Exploratory SURPASS-CVOT analysis compares tirzepatide and dulaglutide outcomes by heart failure history

An exploratory SURPASS-CVOT analysis compared tirzepatide, up to 15 mg weekly, with dulaglutide, 1.5 mg weekly, in patients with type 2 diabetes and atherosclerotic cardiovascular disease, stratified by heart failure (HF) history. Follow-up averaged four years; 20.3% had prior HF. Endpoints included major adverse cardiovascular events and composites of death with HF hospitalization or urgent visits. The supplied abstract did not report sample size.

Among patients with HF, the hazard ratio for all-cause death or HF hospitalization or urgent visits was 0.83 (95% CI 0.70–0.99) with tirzepatide versus dulaglutide; without HF, it was 0.88 (0.78–1.00). For MACE-4—cardiovascular death, myocardial infarction, stroke or coronary revascularization—the corresponding estimates were 0.81 (0.69–0.95) and 0.91 (0.83–1.00). Confidence intervals crossed 1 for both MACE-3 and the composite of cardiovascular death or HF events in each subgroup. Patient-reported APPADL and EQ-5D-5L visual analogue scores improved and were higher with tirzepatide in both groups.

The findings suggest potential benefit for selected composite outcomes among patients with established HF, following overall non-inferiority in the trial. However, this was an exploratory analysis, and the abstract provides neither absolute event rates nor interaction testing to establish whether treatment effects differ by HF history. Full text was unavailable for assessment.