# SURPASS-CVOT: tirzepatide against dulaglutide on major cardiovascular events

Study · id `cardio:surpass-cvot` · Cardiovascular Atlas · release `f6f6f1b6f50379ed` (public)

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Also called: SURPASS-CVOT

Browse, organ or system: Heart; Metabolism  
Browse, condition area: Diabetes and metabolic disease  

## In plain language

A large trial of people with type 2 diabetes and heart or blood-vessel disease that compared tirzepatide with dulaglutide, another weekly diabetes injection that has been shown to lower the chance of heart events. Tirzepatide was found to be no worse than dulaglutide for heart attack, stroke and heart-related death. It was not shown to be better.

## Technical summary

Active-comparator, double-blind, noninferiority trial sponsored by Eli Lilly (NCT04255433). 13,299 patients were randomized; the modified intention-to-treat population was 6586 on tirzepatide (up to 15 mg weekly) and 6579 on dulaglutide (1.5 mg weekly). The primary composite (cardiovascular death, myocardial infarction or stroke) occurred in 801 (12.2%) and 862 (13.1%): hazard ratio 0.92 (95.3% CI 0.83 to 1.01; P=0.003 for noninferiority; P=0.09 for superiority).

## Key facts

- Design: Multicenter, randomized (1:1), double-blind, active-comparator-controlled noninferiority trial with parallel groups. The registry records phase 3 and double masking.
- Phase: Phase 3
- Enrolled: 13299 participants (enrolled count; A Study of Tirzepatide (LY3298176) Compared With Dulaglutide on Major Cardiovascular Events in Participants With Type 2 Diabetes, snapshot `cardio:ctgov-nct04255433-2026-10-14`, retrieved 2026-10-14)
- Started: 2020-05-29 (actual) (A Study of Tirzepatide (LY3298176) Compared With Dulaglutide on Major Cardiovascular Events in Participants With Type 2 Diabetes, snapshot `cardio:ctgov-nct04255433-2026-10-14`, retrieved 2026-10-14)
- Primary completion: 2025-06-12 (actual) (A Study of Tirzepatide (LY3298176) Compared With Dulaglutide on Major Cardiovascular Events in Participants With Type 2 Diabetes, snapshot `cardio:ctgov-nct04255433-2026-10-14`, retrieved 2026-10-14)
- Completion: 2025-06-12 (actual) (A Study of Tirzepatide (LY3298176) Compared With Dulaglutide on Major Cardiovascular Events in Participants With Type 2 Diabetes, snapshot `cardio:ctgov-nct04255433-2026-10-14`, retrieved 2026-10-14)
- Results first posted: 2026-07-08 (actual) (A Study of Tirzepatide (LY3298176) Compared With Dulaglutide on Major Cardiovascular Events in Participants With Type 2 Diabetes, snapshot `cardio:ctgov-nct04255433-2026-10-14`, retrieved 2026-10-14)
- Countries: United States; Argentina; Australia; Austria; Belgium; Brazil; Canada; China; Czechia; France; Germany; Greece; Hungary; India; Israel; Italy; Japan; Mexico; Netherlands; Poland; Puerto Rico; Romania; Russia; Slovakia; South Korea; Spain; Sweden; Taiwan; Ukraine; United Kingdom; Türkiye (A Study of Tirzepatide (LY3298176) Compared With Dulaglutide on Major Cardiovascular Events in Participants With Type 2 Diabetes, snapshot `cardio:ctgov-nct04255433-2026-10-14`, retrieved 2026-10-14)
- Care setting: Not reported
- Registry status: "COMPLETED" (U.S. National Library of Medicine (ClinicalTrials.gov), snapshot `cardio:ctgov-nct04255433-2026-10-14`, retrieved 2026-10-14)

## Connected pages

- Tests tirzepatide: Tirzepatide (`cardio:tirzepatide`)
- Lists type 2 diabetes as its condition: Type 2 diabetes (`cardio:type-2-diabetes`)
- Lead sponsor on the registry record: Eli Lilly and Company (`cardio:eli-lilly`)
- Lists the HbA1c change as a secondary outcome: HbA1c blood test (`cardio:hba1c`)
- The Mounjaro label reports this trial in section 14.6: Tirzepatide (Mounjaro) (`cardio:mounjaro`)

## Provenance

Content hash: b8e0d0811027ab1d547da3026e74448816069da8669a8cdc766c88e36e5466ba
Last substantive edit: 2026-10-15
Evidence last checked: Not recorded