SynthesisNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025

Effect of Tirzepatide on arrhythmic, major cardiovascular, and neurological outcomes in patients with type 2 diabetes: A systematic review and meta-analysis.

Rui Wu, Bo Xing, Zijun Zhou, Liming Yu, Huishan Wang

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph read 2 numbers from its abstract, feeding 1 cell of the map, but none could be read as for or against, so it casts no vote. Not yet cited in PubMed.

2numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Read, but not usablea number the graph found but could not read as for or against

Cardiovascular eventsan association or prognostic statement, not a treatment comparison · arrhythmia, ascvdfeeds one cell of the map
RR 1.140.20 to 6.55
Tirzepatide was not associated with a statistically significant increase in arrhythmic outcomes, including atrial fibrillation (AF) (RR 1.39, 95% CI 0.53 to 3.67) and atrial flutter (AFL) (RR 1.14, 95% CI 0.20 to 6.55).
Cardiovascular eventsan association or prognostic statement, not a treatment comparison · arrhythmia, ascvdfeeds one cell of the map
RR 1.390.53 to 3.67
Tirzepatide was not associated with a statistically significant increase in arrhythmic outcomes, including atrial fibrillation (AF) (RR 1.39, 95% CI 0.53 to 3.67) and atrial flutter (AFL) (RR 1.14, 95% CI 0.20 to 6.55).

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GIP/GLP-1 & amylin agonists×cardiovascular events

No readable resultOpen on the map →What to test next →

2 readable studies in this cell: 2 favour the treatment, 0 find no difference, 0 favour the comparator.

Belief with this paper
0.50one trial · 1 family supports, 0 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT04847557731 enrolled · 2021
HR 0.620.41 to 0.95
NCT05564039282 enrolled · 2022
OR 20.48.40 to 49.8

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

5 authors.

Rui WuSchool of Life Sciences and Biopharmaceuticals, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning, 110016, People's Republic of China.ORCID http://orcid.org/0009-0009-5352-4506
Bo XingSchool of Life Sciences and Biopharmaceuticals, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning, 110016, People's Republic of China.
Zijun ZhouState Key Laboratory of Frigid Zone Cardiovascular Disease, Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, 83 Wenhua Road, Shenyang, Liaoning, 110016, People's Republic of China.
Liming YuState Key Laboratory of Frigid Zone Cardiovascular Disease, Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, 83 Wenhua Road, Shenyang, Liaoning, 110016, People's Republic of China. lmyu2012@163.com.ORCID http://orcid.org/0000-0001-5953-5016
Huishan WangSchool of Life Sciences and Biopharmaceuticals, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning, 110016, People's Republic of China. huishanw@126.com.ORCID http://orcid.org/0000-0001-6523-7488

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundTirzepatide, a dual GIP/GLP-1 receptor agonist, is effective for glycemic control in type 2 diabetes (T2D), but its impact on cardiovascular (CV) and neurological safety remains uncertain. This meta-analysis evaluated the risks of arrhythmic, major CV, and neurological outcomes associated with tirzepatide.

methodsA comprehensive search of the PubMed, Embase, and Cochrane databases was conducted to identify eligible randomized controlled trials (RCTs) reporting arrhythmic, major CV, and neurological outcomes published up to February 2025. Additionally, subgroup analyses were conducted by age, BMI, diabetes duration, and comparator type.

resultsTwelve RCTs involving 10,615 patients with T2D were included. Tirzepatide was not associated with a statistically significant increase in arrhythmic outcomes, including atrial fibrillation (AF) (RR 1.39, 95% CI 0.53 to 3.67) and atrial flutter (AFL) (RR 1.14, 95% CI 0.20 to 6.55). For major CV outcomes, no significant differences were observed for acute myocardial infarction (RR 0.66, 95% CI 0.38 to 1.17) or coronary artery disease (RR 0.62, 95% CI 0.32 to 1.18). Neurologically, tirzepatide significantly increased the risk of dizziness (RR 1.64, 95% CI 1.04 to 2.57), whereas the risks of headache (RR 1.00, 95% CI 0.65 to 1.55) and transient ischemic attack (RR 1.43, 95% CI 0.44 to 4.61) were not significant. Subgroup analyses suggested higher dizziness risk in patients aged ≤ 60 years.

conclusionsTirzepatide does not significantly increase arrhythmic or major CV risks but is associated with a higher risk of dizziness. Findings from CV and neurological perspectives support targeted patient monitoring and guide future prospective studies.

Indexed as

Arrhythmias, CardiacCardiovascular DiseasesDiabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsNervous System DiseasesTirzepatideHumansRandomized Controlled Trials as TopicGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsTirzepatideArrhythmicCardiovascularMeta-analysisNeurologicalTirzepatideType 2 diabetes

Identifiers

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.