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# Tirzepatide starters had slightly less new heart failure than semaglutide starters
- URL: https://www.coios.me/tirzepatide-starters-had-slightly-less-new-heart-failure/
- Published: 2026-09-28T06:21:51.000Z
- Updated: 2026-09-28T07:06:51.000Z
- Description: In a propensity-matched cohort of 848,538 patients with obesity drawn from TriNetX records, one-year new-onset heart failure was 1.0% among tirzepatide initiators versus 1.3% among semaglutide initiators (HR 0.9), with lower all-cause mortality also reported for tirzepatide.
- Author: Daniel Ryan
- Tags: Healthcare today, Heart and stroke, Obesity, diabetes and GLP-1, United States, #preprint, #refines, #item, #source-2026-09

A retrospective cohort study used pooled TriNetX electronic health records to compare 424,269 patients with obesity initiating tirzepatide with an equal number initiating semaglutide between June 2021 and August 2026\. One-year incidence of new-onset heart failure was 1.0% with tirzepatide against 1.3% with semaglutide, an absolute difference of 0.3 percentage points (HR 0.9, 95% CI 0.86-0.93), with lower all-cause mortality and lower new-onset systolic heart failure in the tirzepatide group and no difference in atrial fibrillation or flutter.

*Why it is interesting: A head-to-head comparison of the two leading incretin drugs on a hard cardiovascular endpoint, though observational and with modest absolute differences.*

Source

[medRxiv, 26 September 2026](https://doi.org/10.64898/2026.09.21.26363546?ref=coios.me)

DOI

10.64898/2026.09.21.26363546

Type

Preprint

Design

Retrospective propensity-matched cohort, TriNetX electronic health records, 424,269 per arm, initiations Jun 2021–Aug 2026, one-year follow-up

Verdict

Refines prior evidence

Driver

[Heart and stroke](https://www.coios.me/d-cardiovascular/)

Driver

[Obesity, diabetes and GLP-1](https://www.coios.me/d-obesity-diabetes/)