- Database study compares protective effect of new GLP-1-based drugs in cardiovascular risk patients
- Evident heart benefits beyond weight loss
- Only few differences in effectiveness between semaglutide and tirzepatide for heart health
Injectable weight-loss drugs can reduce the risk of serious cardiovascular events for people with type 2 diabetes. Researchers at the Technical University of Munich (TUM) and Harvard Medical School have demonstrated this in using insurance claims data. They found that semaglutide and tirzepatide – marketed as Ozempic and Mounjaro – reduced the risk of serious cardiovascular events by up to 18 percent.
The study, published in Nature Medicine, analyzed a large dataset from US health insurers. "Those data are collected in routine clinical care and can be used for research. They allow us to answer a broad range of relevant questions efficiently. Importantly, we are studying patients who reflect everyday clinical practice – unlike the highly selected participants typically enrolled in randomized trials,” says Dr. Nils Krüger, first author of the study and a resident physician at the Department of Cardiovascular Diseases at the TUM University Hospital German Heart Center.
Both substances provide cardioprotective effects
The study demonstrates clear cardiovascular benefits for high-risk patients with type 2 diabetes. Compared with sitagliptin, a diabetes drug shown in previous studies to have no cardiovascular benefit, semaglutide reduced the risk of stroke and heart attack by 18 percent. Tirzepatide lowered the combined risk of stroke, heart attack, and death by 13 percent compared to dulaglutide, a GLP-1 drug that has been in clinical use for several years.
"Both substances have a cardioprotective effect. Our data show that the benefits emerge from early on, indicating that the effect goes beyond weight loss alone," says Dr. Krüger. The exact mechanisms driving this protective effect are still unclear.
As the two GLP-1 drugs have only been available for a short time, there has been a lack of studies demonstrating cardiovascular benefits in addition to weight loss – especially those directly comparing tirzepatide and semaglutide. According to the researchers, such comparative data are urgently needed to better protect at-risk patients. The interdisciplinary team led by Dr. Krüger at TUM University Hospital German Heart Center, Harvard Medical School and Brigham and Women's Hospital aims to close this evidence gap.
Only minor differences between the two drugs
“According to the manufacturers’ claims, each one suggests its own product is more effective than the competitor’s at reducing cardiovascular risk," says Prof. Heribert Schunkert, Director of the Department of Cardiovascular Diseases at TUM University Hospital. “Our study, however, shows only small differences in heart outcomes between tirzepatide and semaglutide in the risk groups we analyzed.”
Dr. Nils Krüger adds: "We hope our findings will provide clarity to physicians about how these new medications perform in clinical practice. Our transparent study design is also intended to support open scientific discussion about whether and how modern GLP-1 drugs should become part of the standard therapeutic repertoire in cardiovascular medicine.”
Publication:
Krüger, N., Schneeweiss, S., Desai, R.J. Cardiovascular outcomes of semaglutide and tirzepatide for patients with type 2 diabetes in clinical practice. Nat Med (2025). DOI: 10.1038/s41591-025-04102-x
Further information:
- Recently, Dr. Krüger's team was able to show that treatment with semaglutide or tirzepatide can reduce health risks for people with heart failure with preserved ejection fraction by over 40 percent. The study has been published in the journal JAMA (PMID: 40886075).
- This work was funded by the National Institutes of Health (R01-HL141505, R01-AR080194) and the German Heart Foundation (S/02/24, SRF-HF/24, RWE/11/25).
- This news item on tum.de: https://www.tum.de/en/news-and-events/all-news/press-releases/details/obesity-drugs-improve-heart-health
Subject matter expert:
Dr. Nils Krüger
Technical University of Munich
TUM Klinikum Deutsches Herzzentrum
nils.kruger@tum.de
Prof. Dr. Heribert Schunkert
Director of the Clinic for Cardiovascular Diseases
Technical University of Munich
TUM Klinikum Deutsches Herzzentrum
heribert.schunkert@tum.de
TUM Corporate Communications Center contact:
Paul Hellmich
Media Relations
Tel. +49 (0) 89 289 22731
presse@tum.de
www.tum.de
Journal
Nature Medicine
Method of Research
Data/statistical analysis
Subject of Research
People
Article Title
Cardiovascular outcomes of semaglutide and tirzepatide for patients with type 2 diabetes in clinical practice
Article Publication Date
9-Nov-2025
COI Statement
Dr Schneeweiss reported personal fees from Aetion Inc, a software-enabled analytics company, and grants from Bayer, UCB, and Boehringer Ingelheim to Brigham and Women’s Hospital outside the submitted work. Dr Schunkert reported personal fees from AstraZeneca, Bayer Vital GmbH, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, MSD, Novartis, Pharmacosmos, Sanofi, Servier, Synlab, Amgen, and Amarin outside the submitted work. Dr Wang reported personal fees from MITRE, a federally funded research and development center for the Centers for Medicare & Medicaid Services and personal fees from Cytel Inc during the conduct of the study. No other disclosures were reported