Journal Article

Bridging the gap between GLP1-receptor agonists and cardiovascular outcomes: evidence for the role of tirzepatide

Paolisso, Giuseppe, Capuano, Annalisa, Pesapane, Ada, Vietri, Maria Teresa, Tortorella, Giovanni, Taktaz, Fatemeh, Barbieri, Michelangela, Scisciola, Lucia, Ghosh, Puja, Fontanella, Rosaria Anna, Puocci, Armando, Basilicata, Manuela Giovanna, Franzese, Martina

2024

Overview

Tirzepatide is a new drug targeting glucagon-like peptide 1(GLP1) and gastric inhibitory polypeptide (GIP) receptors. This drug has demonstrated great potential in improving the clinical outcomes of patients with type 2 diabetes. It can lead to weight loss, better glycemic control, and reduced cardiometabolic risk factors. GLP1 receptor agonists have been proven effective antidiabetic medications with possible cardiovascular benefits. Even though they have been proven to reduce the risk of major adverse cardiovascular events, their effectiveness in treating heart failure is unknown. Unlike traditional GLP1 receptor agonists, tirzepatide is more selective for the GIP receptor, resulting in a more balanced activation of these receptors. This review article discusses the possible mechanisms tirzepatide may use to improve cardiovascular health. That includes the anti-inflammatory effect, the ability to reduce cell death and promote autophagy, and also its indirect effects through blood pressure, obesity, and glucose/lipid metabolism. Additionally, tirzepatide may benefit atherosclerosis and lower the risk of major adverse cardiac events. Currently, clinical trials are underway to evaluate the safety and efficacy of tirzepatide in patients with heart failure. Overall, tirzepatide’s dual agonism of GLP1 and GIP receptors appears to provide encouraging cardiovascular benefits beyond glycemic control, offering a potential new therapeutic option for treating cardiovascular diseases and heart failure. Graphical abstract

• Publisher: BioMed Central,Springer Nature B.V,BMC
• Subject: Agonists / Angina pectoris / Angiology / Animals / Anti-inflammatory agents / Anti-Inflammatory Agents - adverse effects / Anti-Inflammatory Agents - therapeutic use / Antidiabetics / Arteriosclerosis / Atherosclerosis / Autophagy / Biomarkers - blood / Blood Glucose - drug effects / Blood Glucose - metabolism / Blood pressure / Body weight loss / Cardiology / Cardiomyocytes / Cardiovascular disease / Cardiovascular diseases / Cardiovascular Diseases - drug therapy / Cardiovascular Diseases - prevention & control / Cardiovascular health / Cardiovascular system / Cardiovascular System - drug effects / Cardiovascular System - metabolism / Cardiovascular System - physiopathology / Cell death / Clinical outcomes / Clinical trials / Congestive heart failure / Diabetes / Diabetes mellitus (non-insulin dependent) / Diabetes Mellitus, Type 2 - blood / Diabetes Mellitus, Type 2 - drug therapy / Ejection fraction / Gastric Inhibitory Polypeptide / GIP receptor / GLP-1 receptor / GLP1 receptor agonists / Glucagon / Glucagon-like peptide 1 / Glucagon-Like Peptide-1 Receptor - metabolism / Glucagon-Like Peptide-1 Receptor Agonists / Glucagon-Like Peptide-2 Receptor / Glucose / Glucose metabolism / Health risks / Heart attacks / Heart diseases / Heart failure / Humans / Hypoglycemic Agents - adverse effects / Hypoglycemic Agents - pharmacology / Hypoglycemic Agents - therapeutic use / Incretins - adverse effects / Incretins - therapeutic use / Inflammation / Insulin / Kinases / Lipid metabolism / Medicine / Medicine & Public Health / Metabolism / Novel Cardioprotective Antidiabetic Medications / Obesity / Overweight / Patients / Peptides / Phosphorylation / Proteins / Receptors, Gastrointestinal Hormone - agonists / Receptors, Gastrointestinal Hormone - metabolism / Review / Risk Assessment / Risk factors / Signal Transduction - drug effects / Tirzepatide / Treatment Outcome