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Retatrutide’s Phase 3 TRIUMPH, Cardiac Drones, and TAVR’s MR Impact
By Viktor Zarev, Virginia Hunt
October 1, 2026
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Together with
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“I love running a nonprofit hospital. Every time someone questions the money, I show them a photograph of a nurse holding a newborn.”
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Dutch Rojas
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One of the best things a well done trial can give us is data that actually represents a patient population. That’s why I’m very excited to announce our next webinar featuring Fatima Rodriguez, MD, MPH from Stanford and Michelle Gearthart, PharmD from Cleerly. They’ll be discussing how the results of the CONFIRM2 trial can reveal cardiovascular risk beyond the conventional factors. You can register here.
Now, in terms of conventional CV risk factors, one of the most impactful and widespread is obesity. Today’s top story tells us Eli Lilly has yet another solution for that risk factor.
Thanks for reading,
Vik
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Cardiology Pharmaceuticals
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Ladies and gents, Eli Lilly has outdone itself again, with the Phase 3 results of its triple GLP-1/GIP/glucagon receptor agonist, retatrutide, showing astonishing weight loss results for patients with obesity.
- Most people are already familiar with Novo’s Ozempic, which targets just the GLP-1 receptor and Lilly’s Mounjaro, which targets both the GLP-1 and GIP receptors.
- Retatrutide takes it a step further and targets those receptors as well as the glucagon receptor, which means it increases calorie burning and fat breakdown.
- This has far reaching implications for cardiovascular risk, since visceral fat mass has been shown to directly increase CVD risk through cytokine release, high BP, and high LDL-C.
Doing the due diligence in testing this additional receptor design, Eli Lilly’s TRIUMPH-1 trial randomized 2.3k adults with obesity but without diabetes to one of three retatrutide doses or placebo and followed up after 80 weeks.
- The lowest dose, 4mg, led to a 17.6% weight reduction.
- Upping that to 9mg led to a 23.7% weight reduction.
- At the highest dose of 12mg, weight reduction was 25%.
- Meanwhile placebo patients saw a 3.9% weight reduction.
Those weight-loss numbers are among the highest reported for the GLP-1 drug class, with even placebo-adjustment of the data showing weight loss of roughly 20–21 percentage points at the two higher doses.
- The tapering off of weight loss effect between the 9mg and 12mg dose is likely due to the limited amount of receptors the drug can act on at once (receptor saturation).
- For reference, the maximum clinical doses of Mounjaro and Ozempic lead to 22% and 15% average bodyweight reduction, respectively.
Beyond weight, retatrutide improved two clinically important complications that enrolled patients faced: knee osteoarthritis and sleep apnea, the latter of which is also a direct CV risk factor caused by excessive body weight.
- Roughly 10% of patients enrolled with obstructive sleep apnea.
- Those on the two highest doses of retatrutide saw their nighttime hypoxic events decrease by over 30 less per night throughout the study
Retatrutide’s most common adverse events were gastrointestinal but the trial reported no unexpected safety issues beyond that familiar pattern.
- Taking retatrutide also led to mild heart rate elevation (~6 bpm), though it’s unlikely this would be a safety issue down the line.
The Takeaway
Eli Lilly’s Mounjaro isn’t exactly an old drug by any means, so it’s not like it needed a direct sequel with retatrutide, but it’s hard to deny how compelling of an improvement these results are. By adding glucagon receptor agonism to how we treat obesity, it looks like patients will have yet another more effective option for reducing one of their biggest CVD risk factors.
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Most Health Systems Have Deployed AI. Few Have Scaled It.
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- Whose MR Eases After TAVR? TAVR helps most aortic stenosis patients with concurrent mitral regurgitation find some MR relief, but the procedure isn’t equally effective or safe for everyone. Among 344 patients who underwent TAVR, MR improved to mild or less in 53% of patients, including those with low-flow low-gradient (LFLG) AS. Yet a deeper analysis showed that women and patients with hypertension were 51% and 74% less likely to achieve those results, respectively. Plus, mortality rates were much higher for those LFLG patients whose severe MR persisted post-TAVR.
- Repairing the Heart: The heart is resilient, but it’s not usually resilient enough to repair itself after a heart attack — though maybe it could be. A new Nature Cardiovascular Research study showed that inhibiting the metabolic powerplayer succinate dehydrogenase in mice cardiac cells enabled the activation of a regenerative cascade while suppressing fibrosis-associated genes. The processes paralleled those that allow newborn hearts to functionally recover from injury, potentially signalling a new therapeutic pathway which relies upon latent natural mechanisms.
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- Two Scans Beat One in Myocarditis Risk: New research suggests that pairing FDG PET/CT imaging with cardiac MRI offers prognostic value over MRI alone in patients with suspected myocarditis. In a JNC study of 100 patients, those with matching heart abnormalities on both scan types faced nearly four times the MACE risk at one year compared to those whose CMR and PET/CT scans didn’t match (aHR: 3.61). The study’s authors say matching scan findings warrants treating myocarditis patients differently, like adding loop recorders for arrhythmia monitoring.
- Clinical AI Needs More Than Accuracy: Examining roughly 50 FDA-cleared algorithms across 2k hospitals and 11M patients, a new NEJM AI article argues that regulatory clearance and strong performance aren’t enough to drive clinical AI adoption. In the case of AI for ECG-detected HCM, researchers found that 70+% of alerts got reviewed, time to review a case went down from 45 minutes to 15 minutes, and users who rarely logged in became daily active users. However, real-world bottlenecks like physician availability, charting time, and overall workload stand in the way of implementation.
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- A Fourth ECG-AI Tool for Tempus: Tempus AI received FDA 510(k) clearance for its Tempus ECG-MR AI product that analyzes standard 12-lead ECGs to detect signs of undiagnosed moderate or severe mitral regurgitation. It’s the company’s fourth FDA-cleared ECG-AI product, now spanning arrhythmia, heart function, pulmonary vascular, and valvular disease. Intended for at-risk patients 65 and older, the tool provides a binary output to flag candidates for follow-up imaging, complementing rather than replacing other diagnostics.
- Cardiac Arrest Rescue Drones: A simulation study presented at the European Emergency Medicine Congress suggests drones could greatly speed-up defibrillator delivery to out-of-hospital cardiac arrests. Modeling three AED delivery strategies across the Île-de-France region, researchers found that a hybrid approach combining fixed AEDs with drones cut access times by an average of 3.76 minutes. As a result, the drones AEDs to over 95% of cases within five minutes versus just 30-40% relying on road transport.
- Refreshed CV Guidelines for Surgery Patients: Non-cardiac surgery on cardiac patients can have tricky implications. To address this, a coalition of cardiovascular societies led by the AHA and ACC released the 2026 guidelines for managing CV conditions in adults undergoing noncardiac surgery. The guidelines draw on a comprehensive literature search to update and replace the 2014 guidelines with new evidence-based strategies for surgeons to consider. The new list spans pharmacological therapies, perioperative monitoring, and devices for managing cardiovascular disease in surgical patients.
- AHA Statement on Hispanic Heart Health: Speaking of the AHA, it released a scientific statement highlighting the disproportionate cardiovascular burden among U.S. Hispanic adults. Per the statement, among the 70M Americans classified under the U.S. Census definition of Hispanic, obesity affects nearly 46%, hypertension affects 44%, and diabetes more than 15%, twice the “non-Hispanic” white rate. Of note, the term “Hispanic” was created by the Nixon administration for political representation purposes rather than genetic profiling, so the clinical gravity of these stats is hard to define.
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Pulmonary Hypertension Detection With a Single Echo Clip
Pulmonary hypertension is often diagnosed late, when irreversible vascular remodelling has already occurred. That’s changing, however, with Us2.ai’s spatiotemporal transformer technology that can process apical four-chamber echo and accurately detects pulmonary hypertension far beyond the single-view echocardiographic benchmark.
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A Cardiovascular Ultrasound Platform You Can Trust
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The Benefits of Cardiovascular Structured Reporting
Cardiovascular imaging’s growing demand means providers need structured reporting to manage their clinical workflows. Discover why Optum’s structured reports allow for more automated EHR and modality data while helping standardize clinical workflows.
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- PIA Medical Processes It All: Need an analysis like calcium scoring, strain or even FFR? PIA Medical began as a Core Lab and can handle creative cardiac research and clinical trials along with the full breadth of clinical analyses available today.
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- VASCADE MVP® XL Vascular Closure System: Sometimes EP procedures call for a venous vascular closure system that is simply bigger. Haemonetics’ VASCADE MVP XL closure system comes with 58% more collagen and a 9% larger disc compared to the VASCADE MVP system as well as an expanded indication for utilizing 10-14F inner diameter sheaths.
- Canon’s 30 Years of Caring: For over 30 years, Canon has helped advance pediatric interventional cardiology through innovation and a commitment to better care. Learn more about how and why modern pediatric cardiac angiography came to be from one of its founding members, Dr. John P. Cheatham.
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- How Monebo’s AI Genetic Algorithm Makes Technology Smarter: How do you teach a computer to recognize the complex patterns in an electrocardiogram signal? Read about Mondebo’s AI training process and the secret behind their genetic algorithm for ECG analysis.
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