Comparative effectiveness of tirzepatide and DPP-4 inhibitors in type 2 diabetes with heart failure.
I, M., K, P., M, C., Y, A., K, D., AW, L., S, M., K, C., MC, B., & D, J. (2026). Comparative effectiveness of tirzepatide and DPP-4 inhibitors in type 2 diabetes with heart failure.. Diabetes & vascular disease research. https://doi.org/10.1177/14791641261467888
I M, K P, M C, Y A, K D, AW L, et al. Comparative effectiveness of tirzepatide and DPP-4 inhibitors in type 2 diabetes with heart failure.. Diabetes & vascular disease research. 2026; doi: 10.1177/14791641261467888
I M, K P, M C, et al. Comparative effectiveness of tirzepatide and DPP-4 inhibitors in type 2 diabetes with heart failure.[J]. Diabetes & vascular disease research. 2026. DOI: 10.1177/14791641261467888.
@article{i2026,
author = {Mortada I and Paul K and Chammany M and Abraham Y and Devulapally K and Lee AW and Mansour S and Chatila K and Boyars MC and Jehle D},
title = {Comparative effectiveness of tirzepatide and DPP-4 inhibitors in type 2 diabetes with heart failure.},
journal = {Diabetes & vascular disease research},
year = {2026},
doi = {10.1177/14791641261467888},
note = {PMID: 42420805},
}
TY - JOUR AU - Mortada I AU - Paul K AU - Chammany M AU - Abraham Y AU - Devulapally K AU - Lee AW AU - Mansour S AU - Chatila K AU - Boyars MC AU - Jehle D TI - Comparative effectiveness of tirzepatide and DPP-4 inhibitors in type 2 diabetes with heart failure. T2 - Diabetes & vascular disease research PY - 2026 DO - 10.1177/14791641261467888 AN - PMID:42420805 ER -
While patients with type 2 diabetes mellitus (T2DM) and heart failure (HF) are frequently prescribed dipeptidyl peptidase-4 inhibitors (DPP-4is), emerging evidence suggests glucagon-like peptide-1 receptor agonists may offer improved outcomes. This study compared the effectiveness of tirzepatide versus DPP-4i in patients with T2DM and HF. Adults with T2DM and HF treated between 2022 and 2025 were included. Cohort A comprised patients receiving tirzepatide, and Cohort B comprised patients receiving DPP-4is. Prespecified subgroup analyses were conducted for HF with reduced ejection fraction (HFrEF) and HF with non-reduced ejection fraction (HFnonrEF). Propensity score matching was performed across demographic, clinical, medication, and laboratory covariates. Outcomes included all-cause mortality, hospitalization, HF exacerbation, and major adverse cardiovascular events (MACE). After matching, 8,956 patients were included in each group. Tirzepatide therapy was associated with a lower hazard of all-cause mortality (HR 0.32, 95% CI 0.25-0.42), hospitalizations (HR 0.53, 95% CI 0.48-0.57), HF exacerbation (HR 0.37, 95% CI 0.33-0.42) and MACE (HR 0.79, 95% CI 0.73-0.84). Sub-group analyses for HFrEF and HFnonrEF demonstrated similar trends. In conclusion, among patients with T2DM and HF, treatment with tirzepatide was associated with markedly lower hazards of mortality, hospitalization, HF exacerbation, and MACE compared to DPP-4 inhibitors.