Diabetes & vascular disease research最新文献

{"title":"Circulating lysophosphatidylethanolamine species are associated with pericoronary adipose tissue inflammation and coronary atherosclerotic burden in type 2 diabetes.","authors":"Daopeng Dai, Shuai Chen, Qingrun Li, Chengshuang Chu, Feifei Li, Yipaerguli Maimaiti, Xinrui Wu, Wenli Zhang, Qiujing Chen, Yong Wang, Fenghua Ding, Lin Lu, Rong Zeng, Jinzhou Zhu, Yang Dai","doi":"10.1177/14791641261484961","DOIUrl":"10.1177/14791641261484961","url":null,"abstract":"<p><p>BackgroundType 2 diabetes mellitus (T2DM) involves alterations in lipid metabolism beyond conventional cholesterol profiles. We examined whether specific plasma lipidomic signatures are related to pericoronary adipose tissue (PCAT) inflammation and coronary artery disease (CAD) burden.MethodsThis cross-sectional analysis included 176 T2DM participants from the GADA study. PCAT inflammation was measured by the fat attenuation index (FAI), CAD burden by Gensini/SYNTAX scores and plasma lipid species by targeted LC-MS. Multivariable regression were used to identify lipid species associated with FAI and CAD burden. For lipid species linked to both, mediation analyses were performed.ResultsWe quantified 660 lipid molecular species across 20 classes. Five species were associated with FAI: sphingomyelin (SM) (34:4), phosphatidylcholines (PC) (16:0/20:4), Lysophosphatidylethanolamine (LPE) (18:1), LPE (20:4), and LPE (18:2). The three LPE species remained independently associated with both Gensini and SYNTAX scores after adjustment for clinical risk factors, conventional lipid measures, triglycerides, and hsCRP. Mediation analyses indicated that FAI accounted for part of the associations between these LPE species and CAD burden.ConclusionsIn T2DM patients, circulating LPE (18:1), LPE (20:4), and LPE (18:2) were associated with both PCAT inflammation and CAD burden. These findings point to altered LPE metabolism as a lipid-inflammatory signature linked to residual atherosclerotic burden beyond conventional lipid and glycemic measures.</p>","PeriodicalId":93978,"journal":{"name":"Diabetes & vascular disease research","volume":"23 5","pages":"14791641261484961"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predominantly L-shaped association between hemoglobin glycation index and all-cause mortality in hospitalized patients with heart failure.","authors":"Rui-Yun Wu, Jia-Hao Dou, Chen Guo, Jin Wei","doi":"10.1177/14791641261474039","DOIUrl":"10.1177/14791641261474039","url":null,"abstract":"<p><p>BackgroundHeart failure (HF) is closely associated with abnormalities in glucose metabolism, which substantially influence clinical outcomes. The hemoglobin glycation index (HGI), reflecting the discrepancy between observed and predicted glycated hemoglobin, has emerged as a marker of interindividual variation in glycation beyond conventional HbA1c. However, the prognostic significance of HGI in hospitalized patients with HF remains unclear.MethodsIn this retrospective cohort study, we analyzed data from the MIMIC-IV database and included 3,470 adult patients hospitalized with HF. HGI was calculated as the difference between measured HbA1c and predicted HbA1c derived from fasting plasma glucose, and participants were categorized into quartiles. The primary outcome was 365-day all-cause mortality, and the secondary outcome was 30-day all-cause mortality. Kaplan-Meier survival analysis, restricted cubic spline modeling, multivariable Cox regression, and subgroup analyses were performed to evaluate the association between HGI and mortality.ResultsAmong the 3,470 included patients, 837 (24.1%) died within 365 days after discharge. Restricted cubic spline analysis demonstrated a predominantly L-shaped association between HGI and both 30-day and 365-day all-cause mortality, with excess mortality risk mainly concentrated at low HGI values. In multivariable Cox models, compared with the lowest quartile, higher HGI quartiles were associated with significantly lower risks of both short-term and long-term mortality, supporting the particular vulnerability of patients with extremely low HGI. Subgroup analyses generally supported the robustness of these findings, although a significant interaction with diabetes status was observed for 365-day mortality.ConclusionsHGI was independently associated with short-term and long-term all-cause mortality in hospitalized patients with HF, with a predominantly L-shaped pattern observed. Excess mortality risk was mainly concentrated at low HGI values. HGI may serve as a simple and accessible marker for risk stratification in this population.</p>","PeriodicalId":93978,"journal":{"name":"Diabetes & vascular disease research","volume":"23 5","pages":"14791641261474039"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of sodium-glucose cotransporter 2 inhibitors versus glucagon-like peptide-1 receptor agonists in older patients with type 2 diabetes.","authors":"Ibrahim Mortada, Krishna Paul, James Rice, Noah Joseph, Trevor L Raum, Mohanad Albayyaa, Diann Gaalema, Dietrich Jehle, Thomas A Blackwell, Hani Jneid","doi":"10.1177/14791641261495569","DOIUrl":"https://doi.org/10.1177/14791641261495569","url":null,"abstract":"<p><p>BackgroundType 2 diabetes mellitus (T2DM) increases the risk of cardiovascular and neurocognitive complications. GLP-1 receptor agonists (GLP-1 RAs) and SGLT2 inhibitors (SGLT2is) have pleiotropic effects beyond glycemic control, but comparative long-term data on dementia, cardiovascular events, and mortality in older adults are limited.MethodsThis retrospective cohort study used the TriNetX US Collaborative Network. Adults ≥60 years with T2DM on metformin plus either GLP-1 RAs or SGLT2is (n=56,211 per cohort after matching, 2014-2020) were propensity-score matched on demographic and clinical characteristics. Five-year outcomes included incident Alzheimer's disease, vascular dementia, other dementia, dementia-related medication use, NSTEMI, STEMI, and all-cause mortality.ResultsAfter propensity-score matching, GLP-1 RA use was associated with higher risks of Alzheimer's disease (RR 1.33, 95% CI 1.18-1.48), vascular dementia (RR 1.56, 95% CI 1.39-1.76), other dementia (RR 1.33, 95% CI 1.21-1.47), dementia-related medication initiation, and all-cause mortality (RR 1.11, 95% CI 1.08-1.15) compared with SGLT2is. NSTEMI and STEMI risks did not differ significantly between groups.ConclusionsIn older adults with T2DM, SGLT2is were associated with lower risks of dementia, dementia-related medication use, and all-cause mortality compared with GLP-1 RAs in propensity-score matched cohorts. These observational findings are hypothesis-generating and should be confirmed in prospective studies.</p>","PeriodicalId":93978,"journal":{"name":"Diabetes & vascular disease research","volume":"23 5","pages":"14791641261495569"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid arterial stiffness is associated with selective glomerular hypofiltration of middle-sized molecules in type 2 diabetes.","authors":"Agne Laucyte-Cibulskiene, Elisabeth Kurien Thomas, Isak Lindberg, Peter M Nilsson, Anders Christensson, Jan Nilsson, Michaela Kozakova, Carmela Morizzo, Giuseppe Penno, Monia Garofolo, Carlo Palombo","doi":"10.1177/14791641261493132","DOIUrl":"https://doi.org/10.1177/14791641261493132","url":null,"abstract":"<p><p>BackgroundType 2 diabetes (T2D) is a major driver of premature vascular aging. We investigated whether Selective Glomerular Hypofiltration Syndromes (SGHS), expressed as ratios of cystatin C- or β2-microglobulin-based estimated glomerular filtration rate to creatinine-based eGFR (eGFRcys/eGFRcr and eGFRb2M/eGFRcr), are associated with carotid, femoral, or aortic stiffness.MethodsWe studied 144 individuals with T2D recruited from the University Diabetology Unit of Pisa, Italy. Local arterial stiffness was assessed at the carotid and femoral arteries using β stiffness index, Peterson's elastic modulus (Ep), and local wave speed (WS). Systemic stiffness was evaluated by carotid-femoral pulse wave velocity (cfPWV) and augmentation index (AIx). Kidney function was assessed using eGFRcr, eGFRcys, eGFRb2M, mean eGFR, urinary albumin-to-creatinine ratio (UACR), and eGFR ratios.ResultsA 0.1-unit decrease in eGFRcys/eGFRcr showed a borderline association with higher cfPWV (p=0.087), while age, diabetes duration, UACR, and central pulse pressure were stronger predictors. Lower eGFR ratios were associated with higher carotid WS in unadjusted analyses; after adjustment, eGFRcys/eGFRcr showed a nonsignificant trend (p=0.074). No associations were found with femoral stiffness indices.ConclusionsSGHS was inversely associated with carotid WS in T2D but not with aortic or femoral stiffness.</p>","PeriodicalId":93978,"journal":{"name":"Diabetes & vascular disease research","volume":"23 5","pages":"14791641261493132"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between inflammation and depressive symptoms in diabetes: A scoping review.","authors":"Nathaniel J Smail, Jefferson C Frisbee, Stephanie J Frisbee","doi":"10.1177/14791641261476326","DOIUrl":"10.1177/14791641261476326","url":null,"abstract":"<p><p>Depression is a clinically important comorbidity in people living with diabetes, yet biological pathways linking these conditions remain unclear. Chronic inflammation has been proposed as one mechanism connecting metabolic dysfunction with depressive symptoms. This scoping review examined knowledge on inflammation and depression/depressive symptoms in adults with diabetes, with attention to differences by diabetes type and sex. Thirty-seven studies met inclusion criteria, predominantly observational and focused on type 2 diabetes. Inflammatory markers were more frequently associated with depressive symptoms in type 2 diabetes than in type 1. CRP/hs-CRP was the most commonly studied biomarker and was often positively associated with depressive symptoms, while composite immune-metabolic indices reflected depressive symptom burden across studies. In contrast, findings for individual cytokines, including IL-6 and TNF-α, were heterogenous and appeared dependent on adiposity, metabolic health, or vascular comorbidity. Evidence in type 1 diabetes was less uniform, with studies suggesting involvement of vascular, lipid-associated, or non-classical inflammatory pathways. Sex appeared to modify inflammation and depression associations, although patterns varied across biomarkers and study populations. Overall, the literature suggests that inflammation is relevant to depression in diabetes, particularly in type 2, but that this relationship is heterogeneous and shaped by diabetes type, sex, adiposity, and vascular burden.</p>","PeriodicalId":93978,"journal":{"name":"Diabetes & vascular disease research","volume":"23 5","pages":"14791641261476326"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of antidiabetic agents on COPD exacerbations in patients with type 2 diabetes mellitus: A systematic review and network meta-analysis.","authors":"Muhammed Shabil, Asif Jan, Muhammad Aaqib Shamim, Hussein Aziz Naser, Sourav Sudan, Huma Sultana, Muhammad Imran, Farhad Ullah, Daniel Dubwa, Shubham Kumar","doi":"10.1177/14791641261487590","DOIUrl":"10.1177/14791641261487590","url":null,"abstract":"<p><p>BackgroundThe impact of Antidiabetic Agents on COPD Exacerbations remains uncertain. We conducted a comprehensive review to evaluate the impact Antidiabetic Agents on COPD Exacerbations in patients with T2DM.MethodsWe searched PubMed, Embase, and Web of Science from inception to January 15, 2026 for observational studies involving adults with T2DM and COPD. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models, treatments were ranked using the Surface Under the Cumulative Ranking Curve (SUCRA), and study quality was assessed using the Newcastle-Ottawa Scale.ResultsThirteen studies comprising 755,206 participants were included. Compared with sulfonylureas, SGLT-2 inhibitors were associated with the lowest risk of overall COPD exacerbations (RR 0.71, 95% CI 0.66-0.77), followed by GLP-1 receptor agonists (RR 0.77, 95% CI 0.71-0.84). Metformin demonstrated a near-neutral association (RR 0.89, 95% CI 0.79-1.00), whereas DPP-4 inhibitors (RR 1.05, 95% CI 0.97-1.13) and meglitinides (RR 1.13, 95% CI 0.93-1.36) showed no evidence of benefit. Similar findings were observed for severe exacerbations, with SGLT-2 inhibitors and GLP-1 receptor agonists demonstrating the strongest associations.ConclusionsSGLT-2 inhibitors and GLP-1 receptor agonists were associated with a lower risk of COPD exacerbations than sulfonylureas, whereas metformin showed a near-neutral association and DPP-4 inhibitors and meglitinides showed no clear benefit.</p>","PeriodicalId":93978,"journal":{"name":"Diabetes & vascular disease research","volume":"23 5","pages":"14791641261487590"},"PeriodicalIF":3.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of domestic water hardness with incident diabetic retinopathy and the mediating role of GID8: A UK Biobank prospective cohort study.","authors":"Zhiyi Gu, Yujin Jiang, Xinyu Zhang, Yikeng Huang, Jiajun Xu, Xiaoqian Wu, Xinyu Zhu, Bo Li, Jian Chang, Shuzhi Zhao, Zhi Zheng","doi":"10.1177/14791641261474108","DOIUrl":"10.1177/14791641261474108","url":null,"abstract":"<p><p>PurposeTo investigate the longitudinal association between domestic water hardness and incident diabetic retinopathy (DR) in individuals with type 2 diabetes (T2D) and identify circulating proteomic mediators.MethodsThis study analysed data from 13,194 participants with prevalent T2D. Domestic water hardness was determined according to residential postcodes. Weighted Cox proportional hazards models and mediation analyses were employed to evaluate associations between water hardness, proteins, and DR risk.ResultsDuring a median follow-up of 13.28 years, 1,505 cases of incident DR were documented. Compared with soft water (<60 mg/L), very hard water (>180 mg/L) was associated with a 49% higher risk of DR (HR, 1.49; 95% CI, 1.12-2.00). The plasma protein GID8 (Glucose-induced degradation protein 8) was identified as a mediator, explaining 6.2% (95% CI, 1.2%-25.5%) of the association.ConclusionThese findings provide some preliminary proteomic insights that domestic hard water may be a novel, modifiable environmental risk factor for DR, potentially mediated through GID8-related pathways. Future research should include mechanistic studies to confirm the biological pathways linking domestic water hardness to diabetic retinopathy.</p>","PeriodicalId":93978,"journal":{"name":"Diabetes & vascular disease research","volume":"23 4","pages":"14791641261474108"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of circulating biomarkers and immune subtypes for diabetic retinopathy through multi-cohort integrative analysis.","authors":"Jiwei Zhang, Linglin Zhang, Zhihong Yu, Gaojie Yang, Liling Yu","doi":"10.1177/14791641261474004","DOIUrl":"10.1177/14791641261474004","url":null,"abstract":"<p><p>PurposeTo elucidate the dynamic molecular evolution and immune heterogeneity in diabetic retinopathy (DR) and identify diagnostic biomarkers.MethodsMulti-omics integrative analysis was performed on peripheral blood transcriptomic data from diabetic patients with and without DR. Techniques included differential expression analysis, immune infiltration profiling, unsupervised clustering, and LASSO regression for biomarker selection. Findings were validated in an independent high-glucose-treated endothelial cell model.ResultsDR progression exhibits staged molecular evolution from diabetes (immune suppression) to early DR (cell cycle inhibition, immune burst) and advanced DR (metabolic stress, persistent immune dysregulation). Six co-downregulated immune modules indicated systemic immune suppression. Patients were classified into three immune subtypes: vascular-inflammatory, metabolic disorder, and oxidative stress-tissue remodeling. A diagnostic model based on IK, PLBD2, FLNA, H6PD, and ZMAT2 achieved an AUC of 0.876 for distinguishing DR from diabetes alone.ConclusionThis study delineates the dynamic molecular landscape and immune heterogeneity of DR, providing a potential multi-gene diagnostic signature and a framework for patient stratification, which may facilitate early detection and personalized management.</p>","PeriodicalId":93978,"journal":{"name":"Diabetes & vascular disease research","volume":"23 4","pages":"14791641261474004"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular dynamics in diabetic retinopathy: A systematic review and meta-analysis of ophthalmic Doppler indices in diabetic and non-diabetic populations.","authors":"Muchtar Hanafi, Tonang Dwi Ardyanto, Widiastuti Soewondo, Eti Poncorini Pamungkasari, Muthmainah, Wachid Putranto, Senyum Indrakila","doi":"10.1177/14791641261476327","DOIUrl":"10.1177/14791641261476327","url":null,"abstract":"<p><p>BackgroundOphthalmic Doppler ultrasonography is a non-invasive technique for evaluating hemodynamic changes in diabetic patients. This meta-analysis assessed ophthalmic Doppler indices in diabetic patients with and without retinopathy compared to non-diabetic controls.MethodsWe searched Scopus, PubMed, ScienceDirect, and SpringerLink for studies investigating Doppler ultrasound parameters in diabetic retinopathy (DR). Pooled mean differences with 95% confidence intervals were estimated using random-effects models for peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI), and pulsatility index (PI). Study quality was assessed using QUADAS-2 and QUADAS-C.ResultsFourteen studies (1,217 patients) were included. People with diabetes without retinopathy showed significantly elevated RI (MD 0.08, P=0.004) and PI (MD 0.30, P<0.0001) in the ophthalmic artery versus controls. The central retinal artery showed marked reductions in PSV and EDV (P<0.00001) and increased RI (P=0.001) in established DR. RI was also elevated in the posterior ciliary artery across all diabetic stages. Diagnostic accuracy analyses yielded pooled RI sensitivity of 0.73-1.00 and PI sensitivity of 0.79-1.00.ConclusionOphthalmic artery Doppler indices, particularly RI and PI, were associated with DR severity that may represent possible additional markers of microvascular dysfunction. However, these findings require confirmation in well-designed prospective studies before RI and PI can be considered established early markers.</p>","PeriodicalId":93978,"journal":{"name":"Diabetes & vascular disease research","volume":"23 4","pages":"14791641261476327"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of tirzepatide and DPP-4 inhibitors in type 2 diabetes with heart failure.","authors":"Ibrahim Mortada, Krishna Paul, Michael Chammany, Youstina Abraham, Karthik Devulapally, Aaron W Lee, Shareef Mansour, Khaled Chatila, Michael C Boyars, Dietrich Jehle, Thomas A Blackwell, Hani Jneid","doi":"10.1177/14791641261467888","DOIUrl":"10.1177/14791641261467888","url":null,"abstract":"<p><p>While patients with type 2 diabetes mellitus (T2DM) and heart failure (HF) are frequently prescribed dipeptidyl peptidase-4 inhibitors (DPP-4is), emerging evidence suggests glucagon-like peptide-1 receptor agonists may offer improved outcomes. This study compared the effectiveness of tirzepatide versus DPP-4i in patients with T2DM and HF. Adults with T2DM and HF treated between 2022 and 2025 were included. Cohort A comprised patients receiving tirzepatide, and Cohort B comprised patients receiving DPP-4is. Prespecified subgroup analyses were conducted for HF with reduced ejection fraction (HFrEF) and HF with non-reduced ejection fraction (HFnonrEF). Propensity score matching was performed across demographic, clinical, medication, and laboratory covariates. Outcomes included all-cause mortality, hospitalization, HF exacerbation, and major adverse cardiovascular events (MACE). After matching, 8,956 patients were included in each group. Tirzepatide therapy was associated with a lower hazard of all-cause mortality (HR 0.32, 95% CI 0.25-0.42), hospitalizations (HR 0.53, 95% CI 0.48-0.57), HF exacerbation (HR 0.37, 95% CI 0.33-0.42) and MACE (HR 0.79, 95% CI 0.73-0.84). Sub-group analyses for HFrEF and HFnonrEF demonstrated similar trends. In conclusion, among patients with T2DM and HF, treatment with tirzepatide was associated with markedly lower hazards of mortality, hospitalization, HF exacerbation, and MACE compared to DPP-4 inhibitors.</p>","PeriodicalId":93978,"journal":{"name":"Diabetes & vascular disease research","volume":"23 4","pages":"14791641261467888"},"PeriodicalIF":3.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}