Atrial fibrillation and COPD frequently coexist, both conditions independently increase risks of hospitalization, cardiovascular events, and mortality. Together, they amplify disease severity, leading to worse prognoses. Studies have been exploring therapies that can address this overlap, with tirzepatide drawing attention not only for its weight and glucose-lowering properties but also for its possible anti-inflammatory and cardiovascular benefits.
This study included patients aged 18 years and older diagnosed with both AF and COPD between June 2022 and January 2024. Out of more than half a million eligible patients, 3,728 had been prescribed tirzepatide, while 499,199 served as controls. To ensure a fair comparison, this research used propensity score matching, aligning both groups based on demographics, comorbidities, cardiovascular medications, and heart function measures. After adjustment, 3,726 patients remained in each group.
The patients receiving tirzepatide had lower odds of all-cause mortality within one year when compared to those not on the drug. Also, the odds ratio for death was 0.145, translating into an approximately 85% risk reduction. Beyond survival, tirzepatide was linked to fewer hospitalizations and lower risks of stroke, cardiac arrest, and heart failure exacerbations.
COPD exacerbations, which is a common cause of hospitalization and diminished quality of life, were significantly reduced in the tirzepatide group. Odds of exacerbation fell by nearly half when compared to matched controls.
Also, the patients taking tirzepatide were also less likely to require rhythm-control interventions for atrial fibrillation. The need for anti-arrhythmic drugs, cardioversion procedures, and AF ablation was reduced, which suggested the benefits of drugs may extend to stabilizing heart rhythm in this vulnerable population.
The analysis showed clear and consistent reductions across critical outcomes. Hospitalization odds dropped by about 70%, while the risk of heart failure exacerbation was cut by more than two-thirds. Even the risk of stroke was reduced by nearly 40%.
Overall, these findings highlight a promising therapeutic direction, and the study also caution that observational data, even when carefully matched, cannot establish definitive cause and effect. Prospective, randomized clinical trials will be necessary to confirm tirzepatide’s role in improving outcomes for patients managing both AF and COPD.
Source:
Tan, M. C., Yee, M. F., Vignarajah, A., Pathangey, G., Abdelnabi, M., DeSimone, C. V., Deshmukh, A. J., Sorajja, D., El-Masry, H., & Lee, J. Z. (2025). Exploring the cardiopulmonary effects of tirzepatide in atrial fibrillation and comorbid chronic obstructive pulmonary disease. The American Journal of Medicine. https://doi.org/10.1016/j.amjmed.2025.09.018
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