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The Study

Cardiorenal Outcomes With Tirzepatide Compared With Dulaglutide in Patients With Diabetes and Cardiovascular Disease

In simple terms

This study is like a fair race between two medicines to see which one helps people with diabetes and heart problems have fewer serious health problems. It found that one medicine (tirzepatide) seemed to help more, but we can't say it's the only reason why—other things might have played a role too.

74%

Analysis score

74/ 90

Maximum 90 for a randomized controlled trial.

Where the score came from

Reporting0
Methodology100
Publication100
Statistical77
Study type (basis of the score)
Randomized Controlled Trial
Level 1b - Individual RCT
What’s the bottom line?

Scientists tested two diabetes drugs — one new (tirzepatide) and one older (dulaglutide) — to see which one better prevents heart attacks, strokes, kidney failure, and death in people with diabetes and heart disease.

Where does this study sit?

Reviews of RCTs (Meta-analyses)

Max 100

Randomized Trials

Max 90

Reviews of Cohort Studies

Max 85

Cohort Studies

Max 72

Reviews of Case-Control Studies

Max 63

Case-Control Studies

Max 58

Cross-Sectional & Case Series

Max 50

Expert Opinion

Max 5
StrongerWeaker
Randomized Trials
Level 1b
74

74 / 100

Quality score

Participants are randomly assigned to treatment or control groups, minimizing bias. The gold standard for testing whether an intervention causes an effect.

Can establish causation

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Key takeaways

Summary

Based on the study abstract and findings.

  1. 1Yes — for every 27 people treated with tirzepatide instead of dulaglutide, one major heart or kidney problem was prevented.
  2. 2Over 4 years, 16% fewer people on tirzepatide had heart/kidney problems than those on dulaglutide.
  3. 3Tirzepatide lowered death risk by 16%, heart revascularization by 16%, and kidney disease by 21%.
  4. 4Stroke risk didn't change.

Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data

Publication

Journal

JAMA Cardiology

Year

2026

Authors

Steve E. Nissen, K. Wolski, D. D’Alessio, G. Weerakkody, J. Kiljański, R. Wiese, I. Pavo, B. Cariou, Stephen J. Nicholls

Open Access
4 citations
Analysis v5

Related Content

Claims (6)

Assertion

In patients with type 2 diabetes and heart disease, tirzepatide lowers the combined risk of serious heart and kidney events by 16% compared to dulaglutide.

Causal
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Assertion

In adults with type 2 diabetes and heart disease, tirzepatide is associated with a 16% lower risk of death from any cause over about four years compared to dulaglutide.

Causal
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Assertion

In adults with type 2 diabetes and existing heart disease, tirzepatide and dulaglutide show similar rates of stroke over nearly four years of follow-up, with no statistically significant difference between the two drugs.

Quantitative
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Assertion

In adults with type 2 diabetes and heart disease, a weekly injection of tirzepatide lowers the risk of serious heart and kidney events—such as heart attack, stroke, hospitalization for heart failure, or worsening kidney disease—by 16% compared to another drug called dulaglutide, when used for about 4 years.

Causal
Read analysis
Assertion

In adults with type 2 diabetes and cardiovascular disease, tirzepatide lowers the combined risk of serious kidney outcomes—including worsening protein in the urine, significant decline in kidney function, need for dialysis, or death from kidney disease—by 21% compared to dulaglutide.

Causal
Read analysis
Assertion

In adults with type 2 diabetes and existing heart disease, tirzepatide is associated with a lower rate of procedures to reopen blocked heart arteries compared to dulaglutide, based on a study following patients for about 4 years.

Causal
Read analysis
Fit Body Science verdict — we translate health studies into clear verdicts backed by peer-reviewed research.

Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.