# Tirzepatide vermindert hartfalen en MACE-4-gebeurtenissen sterker dan dulaglutide bij diabetes en hartfalen — SURPASS-CVOT

*geplaatst 2026-10-22 · Hartfalen · European journal of preventive cardiology · doi 10.1093/eurjpc/zwag452 · https://hartvaat.nl/2026/10/15/tirzepatide-vermindert-hartfalen-en-mace-4-gebeurtenissen-sterker-dan-dulaglutid/*

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.

## English: Outcomes in patients with diabetes, atherosclerotic cardiovascular disease, and heart failure treated with tirzepatide or dulaglutide: SURPASS-CVOT analysis.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: European journal of preventive cardiology, https://doi.org/10.1093/eurjpc/zwag452. Bijgewerkt 2026-10-16T01:01:42Z. 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.