Eli Lilly presented the full cardiovascular outcomes data from its SURPASS-CVOT trial at the European Association for the Study of Diabetes (EASD) 2026 meeting in Milan, filling in the details behind headline results the company first released in 2025. The trial compared tirzepatide, the dual GIP/GLP-1 receptor agonist sold as Mounjaro and Zepbound, against dulaglutide (Trulicity), Lilly's older once-weekly GLP-1 drug, in adults with type 2 diabetes and established cardiovascular disease.
What the Trial Found
The study tracked a composite outcome of major adverse cardiovascular events, or MACE, meaning heart attack, stroke, or cardiovascular death. Patients taking tirzepatide had an 8% lower rate of these events compared to those taking dulaglutide. But the confidence interval around that estimate ran from 0.83 to 1.01, meaning it crosses 1.0. In plain terms, the trial met its pre-specified goal of showing tirzepatide is non-inferior to dulaglutide, it doesn't raise cardiovascular risk, but the data don't support a claim that it is statistically superior for preventing these events.
Why Non-Inferior Isn't the Same as Better
Non-inferiority trials are designed to rule out a worse outcome within a pre-set margin, not to prove a better one. SURPASS-CVOT was built around that question because dulaglutide already has an established cardiovascular benefit from earlier trials, so showing tirzepatide performs at least as well matters for prescribing decisions even without a superiority claim. Researchers presenting the data at EASD were careful to frame the 8% figure as a point estimate rather than a proven advantage, since an interval touching 1.01 means the true effect could be anywhere from a meaningful benefit to essentially no difference at all.
How This Fits With Tirzepatide's Other Data
Tirzepatide already carries extensive trial data for diabetes control and weight loss through the SURPASS and SURMOUNT trial programs, covered elsewhere on this site. SURPASS-CVOT adds a dedicated cardiovascular outcomes comparison against an active drug rather than placebo, which is generally considered a higher bar than a placebo-controlled design. The full dataset presented at EASD included secondary endpoints such as heart failure hospitalization and kidney-related measures, though Lilly has not yet published the complete peer-reviewed paper; the EASD presentation is a conference readout, with full journal publication expected to follow.
Regulatory Status
Tirzepatide is FDA-approved for type 2 diabetes (as Mounjaro) and for chronic weight management (as Zepbound). A dedicated cardiovascular-risk-reduction indication would require the FDA to review the complete SURPASS-CVOT dataset once it is formally submitted as part of a label application; that review hasn't happened, and the EASD presentation itself does not change tirzepatide's current FDA label.
The Bottom Line
For people already taking tirzepatide for diabetes or weight management, SURPASS-CVOT is reassuring rather than revelatory: it shows the drug doesn't carry added cardiovascular risk compared to an already-proven option, in a population with existing heart disease. It stops short of showing it's statistically better on that specific measure. Anyone with diabetes and cardiovascular disease weighing treatment options should discuss how trial data like this applies to their own risk profile with their physician rather than drawing conclusions from a single conference presentation.