THE CARDIOVASCULAR IMPACTS OF TIRZEPATIDE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: AN INTEGRATIVE LITERATURE REVIEW

Abstract

Background: Type 2 diabetes mellitus (T2DM) is associated with a high cardiovascular risk, with cardiovascular diseases being the leading cause of mortality in this population. Tirzepatide, a dual agonist of GIP and GLP-1 receptors, has demonstrated promising effects on metabolic control and cardiometabolic risk modulation. Objective: To analyze the cardiovascular and cardiometabolic impacts of tirzepatide in patients with type 2 diabetes mellitus. Methods: This integrative review of the literature was conducted using the PubMed and Virtual Health Library (VHL) databases. The search strategy included the descriptors "tirzepatide", "diabetes mellitus", and "cardiovascular". Randomized controlled trials, systematic reviews, and meta-analyses published within the last five years were included, involving adult patients with T2DM and evaluating cardiovascular outcomes or cardiometabolic parameters. Results: Tirzepatide demonstrated significant reductions in glycated hemoglobin levels, outperforming basal insulin and other antidiabetic agents, while also showing a lower incidence of hypoglycemia. Substantial weight loss was observed, often exceeding 15%, contributing to cardiometabolic risk reduction. Additionally, consistent improvements were observed in blood pressure, lipid profile, and albuminuria, suggesting a potential nephroprotective effect. Regarding cardiovascular outcomes, the studies indicated a favorable safety profile, demonstrating noninferiority and a trend toward a reduction in major adverse cardiovascular events, including myocardial infarction and stroke. Conclusion: Tirzepatide provides significant benefits in glycemic control, weight reduction, and the improvement of multiple cardiometabolic risk factors, while also demonstrating potential cardioprotective effects. These findings support its role as a promising therapeutic strategy for the management of T2DM, particularly in patients with high cardiovascular risk.