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Tirzepatide’s Triumph | Clopidogrel Beats Aspirin
December 9, 2024
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Together with
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“Simply put, there has never been a study demonstrating a diet and exercise approach that reproducibly leads to the sustained average weight losses we see with the newer generations of GLP1 drugs (semaglutide and tirzepatide). Not one. Regardless of your favourite diet or guru.”
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Yoni Freedhoff, MD
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Circle Cardiovascular Imaging made a name for itself in Cardiac MRI, but it’s since developed a full cardiac CT solutions portfolio. Get the latest on Circle CVI and its investments in AI and CT in this Cardiac Wire Show interview with Scott Galbari from RSNA 2024.
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Topline results from the SURMOUNT-5 trial found Eli Lilly’s tirzepatide led to far greater weight loss than Novo Nordisk’s semaglutide, giving Lilly a boost in the race to become America’s go-to GLP-1.
- Semaglutide and tirzepatide both originally received FDA approval for treating adults with T2D, with those approvals later extending to weight loss management.
- Both drugs mimic the GLP-1 hormone, but tirzepatide also mimics another metabolic hormone called GIP.
Over SURMOUNT-5’s 72 week duration, 751 participants across the U.S. and Puerto Rico were randomized to receive the maximum tolerated dose of tirzepatide (10 mg or 15 mg) or semaglutide (1.7 mg or 2.4 mg).
- Tirzepatide led to an average weight loss of 20.2%, well above semaglutide’s 13.7%.
- All patients were either obese or overweight with at least one of the following comorbidities: hypertension, dyslipidemia, obstructive sleep apnea, or CVD.
Tirzepatide also beat out semaglutide in all of the study’s secondary endpoints. Most notably, far more tirzepatide patients achieved 25% body weight reduction than those taking semaglutide (31.6% vs. 16.1%).
These results add to a mounting body of evidence that favors tirzepatide’s GLP-1/GIP targeting mechanism over semaglutide.
- The previous SURMOUNT 3 and 4 trials showed long-term tirzepatide use allows overweight people to shed a massive 26% of their weight, significantly more than semaglutide’s 10.9% to 14.9% reductions.
Despite tizepatide’s apparent advantages, semaglutide still has a sizable sales lead over tirzepatide ($6.8B vs. $4.4B in Q3), due in part to its first-mover status.
The Takeaway
While semaglutide might have been the initial GLP-1 frontrunner, the growing evidence of tirzepatide’s clinical superiority could make it the standard of care for obesity, and potentially the array of other cardiometabolic conditions that GLP-1s have been shown to treat.
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Transforming Ischemia Detection
CCTA AI is poised to transform ischemia detection, leading to far greater diagnostic efficiencies and far fewer unnecessary invasive procedures. See how ischemia’s AI transformation is unfolding in this Cardiac Wire Show interview with Cleerly’s chief medical officer James Earls, MD.
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A Better Way to Coordinate Post-Stroke Care
Think your EHR messaging system might be holding back your post-stroke care? See how UC San Diego Medical Center streamlined its neuro and EP teams’ post-stroke workflow with Viz Connect, and the impact it had on cardiac monitor placements in inpatient and outpatient settings.
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Cloud Transition Success Factors
There are multiple pathways to move your enterprise imaging to the cloud, but certain factors will dictate a successful transition. See how a cloud-native platform enables a range of benefits versus other IT-solution approaches in this Optum white paper.
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- Cleerly Adds $106M: Cardiac CT AI leader Cleerly concluded a $106M Series C extension round, following at least $279M in Series B and C funding raised since 2021. The funding was earmarked for expanding Cleerly’s commercial reach and continues the wave of cardiac CT AI venture capital alongside companies like Elucid ($130M total funding) and HeartFlow ($793M total funding).
- Clopidogrel Over Aspirin For DAPT: Findings from a post-hoc analysis of the HOST-EXAM trial found clopidogrel dual antiplatelet therapy reduced thrombotic and bleeding risks compared to aspirin, regardless of genetic high bleeding risk (HBR) and PCI complexity. Of the study’s 849 patients who underwent PCI, clopidogrel led to a 25% lower risk of thrombotic events in HBR patients and a 38% lower risk in those without HBR. Bleeding risks also lowered in patients with complex (-51%) and noncomplex PCIs (-26%), asserting the drug’s superiority over aspirin regardless of genetic and procedural factors.
- Vista’s CMR Success: Vista announced two-year clinical results showing that its FDA-cleared Vista Cardiac MRI image acquisition software significantly improved workflow efficiency and ensured high-quality CMR imaging consistency by automating MRI technologist tasks. Over the 26 month trial at Mass General Brigham, Vista Cardiac resulted in 26% faster scans, 50% reduction in scan time variability, and 50% more scan slots, enabling 900 additional scans without adding scanners or personnel.
- Insulin Resistance’s AS Impact: Insulin resistance biomarkers could clue-in physicians which patients are at risk of developing aortic stenosis. Researchers followed over 10k patients without AS at baseline for 10.8 years and found several hyperinsulinemia biomarkers were associated with incident AS including fasted, 30 minute, and 120 minute plasma insulin and proinsulin levels, as well as Matsuda index, and serum C-peptide.
- Field Medical PFA Breakthrough: Field Medical announced that its FieldForce Ablation System entered into the FDA’s Total Product Life Cycle Advisory Program Pilot and achieved Breakthrough Device Designation for treating sustained monomorphic scar-related ventricular tachycardia. The FieldForce Ablation System features a single-point contact force PFA catheter that uses proprietary FieldBending technology to deliver targeted high-intensity electric fields to both precise lesions and large volume transmural lesions.
- REALIZEing SZC’s K-Reducing Potential: Sodium zirconium cyclosilicate (SZC) might reduce spironolactone side effects in HFrEF patients prone to hyperkalemia. In the REALIZE-K trial (203 participants), patients taking SZC and spironolactone for 6 months maintained normokalemia at nearly double the rate (71% vs. 36%), while reducing hyperkalaemia risk and discontinuation of spironolactone. However, HF events were higher with SZC (11% vs. 3%).
- CMS Reconsiders GLP-1 Coverage: Amid ongoing cost and supply concerns, researchers estimate that 137M people are eligible for GLP-1s for either weight loss, diabetes, or cardiovascular event prevention. Of those eligible for GLP-1s, 26.8M are on Medicare and 13.8M are on Medicaid. This likely plays into the CMS’ most recent proposal to expand GLP-1 Medicare coverage to obesity treatment, as current rules prohibit coverage when used for weight management and not for CVD or T2D.
- Lung Screening Finds Heart Disease: Canadian researchers writing in CMAJ reported that CT lung cancer screening can detect signs of coronary artery calcium, highlighting the exam’s two-for-one potential. In a population of 1.5k patients screened in Ontario, CAC was detected in 83%, with high CAC levels in 30% of patients.
- Novartis Loses Another Appeal: The U.S. Court of Appeals put another nail in the coffin for Novartis’ bid to block MSN Pharmaceuticals’ generic version of its $6B drug, Entresto. The decision upholds a Delaware federal judge’s August ruling that found Novartis failed to prove patent infringement against MSN, removing a roadblock for the launch of the first U.S. Entresto generic.
- FDA Issues AI Post-Market Rules: The FDA last week issued its final guidance document on predetermined change control plans for AI-enabled medical devices. The guidance creates a regulatory framework for AI developers to monitor their products after they’ve been approved and make changes to accommodate the fact that AI performance changes as algorithms are exposed to new data. The guidance applies to AI devices regulated through the 510(k), de novo, and PMA pathways.
- Reconsidering DAPT Guidelines: A new international consensus statement published in JACC could change the way physicians use dual antiplatelet therapy (aspirin plus a P2Y12 inhibitor) for the prevention of thrombotic events after percutaneous coronary interventions. Due to the bleeding risks associated with DAPT, the statement offers several decision-making algorithms based off of previous trials to help find the balance between bleeding and ischemic risk in patients who need P2Y12 inhibitor therapy.
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Making the Leap to Outsource Post-Processing
Interested in how to outsource cardiac image post-processing, but not sure where to start? PIA walks you through how to assess and compare vendors, understand pricing models and payment options, and outline your requirements to identify vendors who meet your clinical needs.
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Redefining Percutaneous Coronary Intervention
Learn about the AGENT™ Drug-Coated Balloon from Boston Scientific and how this technology is expanding the treatment options for patients with in-stent restenosis in the U.S. Rx only. (Sponsored by Boston Scientific)
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- Accurately Measuring Heart Rate Variability: Heart rate variability measurement and analysis involves two critical elements – the ability to accurately discern the R wave in noisy environments, and using the correct analysis method for a given application. Check out how Monebo’s Kinetic HRV ECG Algorithm excels at both of these essential tasks.
- How to Improve Cardiology Workflows and Get More Patient Time: Complex processes and reporting requirements can mean cardiologists spend more time with clinical systems than they do with their patients. See how Merge Hemo and Merge Cardio work together to help you streamline and scale your clinical and data management workflows, so you can have more time in front of your patients.
- Experience the future of learning: Medtronic Academy 2.0 is here! Unlock your ultimate destination for structural heart medical education with the newly redesigned Medtronic Academy 2.0. Gain access to expert-led courses, webinars, and a wealth of resources to stay ahead in cardiovascular care. Visit now!
- Us2.ai’s Echo Automation Impact: Improving clinician efficiency and quality is the goal for most AI solutions, but we rarely see AI achieve both. See how the AI-ECHO RCT used Us2.ai to achieve both of those goals, while reducing sonographer fatigue in the process.
- Automate Your Echo Reporting: It’s a good feeling when your echo report is already 83% complete before you even sit down to work on it. See how Centricity Cardio Enterprise’s echo automation features make this “good feeling” an everyday occurrence in this quick GE HealthCare demo video.
- New Horizons in Structural Heart: TAVR and TMVR rates are rising rapidly, placing more pressure on interventional planning. Tune into this Circle CVI and Radcliffe Cardiology breakout detailing how to leverage modern CT workflows to produce efficient and accurate pre-procedural plans.
- Cardiology AI: From Research to Clinical Practice: Explore how AI algorithms are reshaping cardiology with insights from Tempus’ recent webinar, featuring Dr. David Ouyang of UCLA and Cedars-Sinai, alongside Tempus’ Dr. John Pfeifer and Dr. Brandon Fornwalt. This expert panel dives into how AI can bridge diagnostic gaps, enhance patient outcomes, and streamline workflows for conditions like AFib and pulmonary hypertension. Read the full recap to glimpse the future of AI-driven cardiology.
- An All-in-One Coronary Care Solution: See how HeartFlow ONE is transforming precision heart care as the first all-in-one CCTA pathway, combining FFRCT, stenosis, and plaque analysis in a single workflow.
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