{"id":"1132ed65307d","type":"article","url":"https://hartvaat.nl/2026/10/15/tirzepatide-vermindert-hartfalen-en-mace-4-gebeurtenissen-sterker-dan-dulaglutid/","title":"Tirzepatide vermindert hartfalen en MACE-4-gebeurtenissen sterker dan dulaglutide bij diabetes en hartfalen — SURPASS-CVOT","title_en":"Outcomes in patients with diabetes, atherosclerotic cardiovascular disease, and heart failure treated with tirzepatide or dulaglutide: SURPASS-CVOT analysis.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"European journal of preventive cardiology","doi":"10.1093/eurjpc/zwag452","source_url":"https://doi.org/10.1093/eurjpc/zwag452","authors":["Stephen J Nicholls","Imre Pavo","Deepak L Bhatt","John B Buse","Stefano Del Prato","Denise R Franco","Steven E Kahn","A Michael Lincoff","Ricardo Fonseca Martins","Darren K McGuire","Vimal Mehta","Debra Miller","Michael A Nauck","Hiroshi Nishiyama","Steven E Nissen","Noémi Nyolczas","Naveed Sattar","Govinda Weerakkody","Russell J Wiese","Bernard Zinman","Sophia Zoungas","David D'Alessio"],"significance":6,"published":"2026-10-22","source_date":"2026-10-15","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/betablokkers-cardiale-indicaties/","https://hartvaat.nl/kennis/farmacologie/glp1-agonisten-cardiologie/"],"congress":"","summary_en":"In a post-hoc analysis of the SURPASS-CVOT trial, patients with type 2 diabetes and established atherosclerotic cardiovascular disease received either tirzepatide or dulaglutide over a mean follow-up of four years. Among patients with a history of heart failure, tirzepatide significantly reduced the composite of all-cause mortality or heart failure events (HR 0.83; 95% CI 0.70–0.99) and MACE-4 (HR 0.81; 95% CI 0.69–0.95) compared with dulaglutide. These exploratory findings suggest tirzepatide may offer superior cardiorenal and heart failure outcomes in this high-risk population, alongside improved patient-reported quality of life.","created":"2026-10-16T01:01:41Z","updated":"2026-10-16T01:01:42Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een post-hoc-analyse van de SURPASS-CVOT-studie kregen patiënten met type 2-diabetes en atherosclerotische CVD gedurende gemiddeld vier jaar tirzepatide of dulaglutide. Bij patiënten met een voorgeschiedenis van hartfalen leidde tirzepatide tot een significant lagere kans op alle-oorzaak overlijden of HF-gebeurtenissen (HR 0,83; 95%BI 0,70-0,99) en MACE-4 (HR 0,81; 95%BI 0,69-0,95) vergeleken met dulaglutide. Deze bevindingen suggereren dat tirzepatide een aantrekkelijk alternatief kan zijn voor GLP-1-agonisten bij diabetespatiënten met comorbid hartfalen, met ook betere patiëntgerapporteerde uitkomsten.","abstract_original":"AIMS: The impact of tirzepatide and dulaglutide on major adverse cardiovascular events (MACE) and heart failure (HF) outcomes according to HF status is unknown. METHODS AND RESULTS: Patients with type 2 diabetes (T2D) and atherosclerotic cardiovascular disease were treated with tirzepatide up to 15 mg or dulaglutide 1.5 mg weekly (average 4 years). The incidence of MACE-3 [cardiovascular (CV) death, myocardial infarction (MI), stroke], MACE-4 (CV death, MI, stroke, coronary revascularization) and composite of all-cause or CV death and hospitalization or urgent visits for HF were analysed in patients with and without a history of HF. A history of HF (20.3%) was associated with more coronary artery disease and prior MI. Incidences of event categories were higher in the HF group. The hazard ratio (HR) for all-cause death or hospitalization or urgent visits for HF on tirzepatide vs. dulaglutide was 0.83 [95% confidence interval (CI) 0.70-0.99] in patients with HF and 0.88 (95%CI 0.78-1.00) without HF. The HR for CV death or hospitalization or urgent visits for HF was 0.85 (95%CI 0.70-1.03) and 0.96 (95%CI 0.83-1.12), for MACE-3 0.90 (95%CI 0.76-1.08) and 0.93 (95%CI 0.83-1.04), and for MACE-4 0.81 (95%CI 0.69-0.95) and 0.91 (95%CI 0.83-1.00) in patients with and without HF, respectively. The patient-reported outcomes of APPADL and EQ-5D-5L visual analogue scores improved and were higher on tirzepatide in both groups. CONCLUSION: With overall non-inferiority established, this exploratory analysis revealed lower rates of the composite of all-cause death or HF events, or MACE-4 among patients with T2D and HF treated with tirzepatide compared with dulaglutide."}