Abstract Body (Do not enter title and authors here): Background:
Tirzepatide (TZP) is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist (RA) that, when compared with dulaglutide, a GLP-1 RA with established cardiovascular (CV) protection in patients with type 2 diabetes (T2D), demonstrated superior glycemic control and weight loss and was evaluated for CV protection in participants with T2D. The present analysis is evaluating the differences in extended major adverse cardiovascular events (MACE) between the two therapy options, and improvements in CV risk factors.
Methods:
SURPASS-CVOT was a Phase 3, event-driven, randomized, active-comparator study to assess the effect of once-weekly (QW) TZP up to 15 mg, on MACE-3 compared to dulaglutide 1.5 mg QW when added to the standard of care in patients with T2D, established CV disease (CVD), and elevated risk for MACE.
Here we investigated the effect of TZP on the composite of CV death, myocardial infarction (MI), stroke, or coronary revascularization (MACE-4) compared to dulaglutide on the total population, a key secondary endpoint, and in subgroups including those with and without history of coronary artery disease (CAD). History of CAD was defined as having any of the following: history of MI, history of coronary revascularization, and/or ≥50% coronary stenosis. We investigated the effect of TZP versus dulaglutide on standalone total coronary revascularization, non-elective or elective/staged coronary revascularization, coronary revascularization via bypass or percutaneous coronary intervention, and coronary revascularization following MI or following unstable angina (UA). We also investigated the effect of TZP versus dulaglutide on hospitalization due to UA, and MACE-5 (MACE-4 with the additional composite of hospitalization due to UA).


Conclusions:
This present analysis will provide insight on the effect of tirzepatide versus dulaglutide with regards to MACE-4 and MACE-5 outcomes, coronary revascularization, and hospitalisation due to UA in participants with T2D, established CVD, and elevated risk for MACE.