Observational studyESC heart failure2026

Semaglutide vs tirzepatide in patients with obesity and HFpEF: a report from a global federated research network.

Luca Monzo, Gianluigi Savarese, Kevin Duarte, Guillaume Baudry, Mark C Petrie, Nicolas Girerd

Abstract readObservational StudyComparative StudyMulticenter Study
In one paragraph

Observational study in ESC heart failure, 2026. The graph read 3 numbers from its abstract, feeding 2 cells of the map, but none could be read as for or against, so it casts no vote. Cited by 3 papers, 1 of them a synthesis that pooled it.

3numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
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 · heart_failure, obesityfeeds 2 cells of the map
HR 1.240.63 to 2.44P = .531
Over a median follow-up of 24 weeks, semaglutide and tirzepatide were associated with a similar risk of the primary composite endpoint (HR 1.14 [95% CI, 0.89-1.46]; P = .286), and of its individual components (all-cause death: HR 1.24 [95% CI, 0.63-2.44]; P = .531; HF hospitalization: HR 1.10 [95% CI, 0.85-1.43]; P = .471), irrespective of diabetes status.
Cardiovascular eventsan association or prognostic statement, not a treatment comparison · heart_failure, obesityfeeds 2 cells of the map
HR 1.140.89 to 1.46P = .286
Over a median follow-up of 24 weeks, semaglutide and tirzepatide were associated with a similar risk of the primary composite endpoint (HR 1.14 [95% CI, 0.89-1.46]; P = .286), and of its individual components (all-cause death: HR 1.24 [95% CI, 0.63-2.44]; P = .531; HF hospitalization: HR 1.10 [95% CI, 0.85-1.43]; P = .471), irrespective of diabetes status.
Cardiovascular eventsan association or prognostic statement, not a treatment comparison · heart_failure, obesityfeeds 2 cells of the map
HR 1.100.85 to 1.43P = .471
Over a median follow-up of 24 weeks, semaglutide and tirzepatide were associated with a similar risk of the primary composite endpoint (HR 1.14 [95% CI, 0.89-1.46]; P = .286), and of its individual components (all-cause death: HR 1.24 [95% CI, 0.63-2.44]; P = .531; HF hospitalization: HR 1.10 [95% CI, 0.85-1.43]; P = .471), irrespective of diabetes status.

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.

GLP-1 receptor agonists×cardiovascular events

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

13 readable studies in this cell: 7 favour the treatment, 2 find no difference, 4 favour the comparator.

Belief with this paper
0.50contested · 7 families support, 3 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT0399313226,774 enrolled · 2018
HR 1.010.91 to 1.11
NCT0357459717,604 enrolled · 2018
HR 0.800.72 to 0.89
NCT013949529,901 enrolled · 2011
HR 0.880.79 to 0.99
NCT039143269,651 enrolled · 2019
HR 0.860.77 to 0.96
NCT011790489,341 enrolled · 2010
HR 0.870.78 to 0.97
NCT038191533,533 enrolled · 2019
HR 0.760.66 to 0.88
NCT017204463,297 enrolled · 2013
HR 0.740.58 to 0.95
NCT026927163,183 enrolled · 2017
HR 0.790.57 to 1.11
OR 1.951.28 to 3.00
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
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

6 authors.

Luca MonzoCHRU de Nancy, Centre d'Investigation Clinique Plurithématique 1433, INSERM, Université de Lorraine, INSERM U1116-DCAC, and F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), 4 Rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.ORCID 0000-0003-2958-943X
Gianluigi SavareseDepartment of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0001-7732-0887
Kevin DuarteCHRU de Nancy, Centre d'Investigation Clinique Plurithématique 1433, INSERM, Université de Lorraine, INSERM U1116-DCAC, and F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), 4 Rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.
Guillaume BaudryCHRU de Nancy, Centre d'Investigation Clinique Plurithématique 1433, INSERM, Université de Lorraine, INSERM U1116-DCAC, and F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), 4 Rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.ORCID 0000-0002-9200-2729
Mark C PetrieSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.ORCID 0009-0003-4517-272X
Nicolas GirerdCHRU de Nancy, Centre d'Investigation Clinique Plurithématique 1433, INSERM, Université de Lorraine, INSERM U1116-DCAC, and F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), 4 Rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.ORCID 0000-0002-3278-2057

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.

BACKGROUND AND

aimsSemaglutide and tirzepatide have been shown to reduce body weight, improve health status, and lower rates of clinical events in patients with obesity and heart failure with preserved ejection fraction (HFpEF). Although recent data suggest that tirzepatide leads to greater weight loss compared to semaglutide in non-HF populations, it remains uncertain whether these different drugs might result in different clinical event rates. This study aims to compare the rates of clinical outcomes for semaglutide vs tirzepatide in patients with obesity and HFpEF.

methodsIn this non-randomized, observational cohort study, adults with obesity and a concurrent diagnosis of HFpEF who initiated treatment with semaglutide or tirzepatide for the first time between November 2023 and May 2025 were identified using electronic health record data from the TriNetX Global Collaborative Research Network. The primary endpoint was a composite of all-cause mortality and HF hospitalization, evaluated after propensity score matching (PSM).

resultsAmong 3983 patients meeting the study criteria (semaglutide, 2719; tirzepatide, 1264), 1258 remained in each group after PSM (mean age 66 years, 41% male, 77% White, mean body mass index 42 kg/m², 63% with diabetes). Over a median follow-up of 24 weeks, semaglutide and tirzepatide were associated with a similar risk of the primary composite endpoint (HR 1.14 [95% CI, 0.89-1.46]; P = .286), and of its individual components (all-cause death: HR 1.24 [95% CI, 0.63-2.44]; P = .531; HF hospitalization: HR 1.10 [95% CI, 0.85-1.43]; P = .471), irrespective of diabetes status.

conclusionsIn this real-world analysis, no difference was observed between semaglutide and tirzepatide in terms of clinical outcomes among patients with obesity and HFpEF.

Indexed as

Heart FailureObesitySemaglutideStroke VolumeTirzepatideAgedFemaleGlucagon-Like Peptide-1 Receptor AgonistsHumansMaleMiddle AgedTreatment OutcomeGlucagon-Like Peptide-1 Receptor AgonistsSemaglutideTirzepatideHeart failureObesitySemaglutideTirzepatide

Identifiers

PMID41711744
PMCPMC13108322

What Socratic holds

Texttitle and abstract
LicenceCC BY
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.