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RCT SUMMIT - Tirzepatide vs Placebo for Heart Failure with Preserved Ejection Fraction and Obesity, NEJM (2024) [PubMed abstract] The SUMMIT trial enrolled 731 patients with heart failure, an ejection fraction of at least 50%, and a BMI of 30 or more Main inclusion criteria Age 40 years NYHA class II-IV EF 50% BMI 30 KCCQ-CSS of 80 or lower Main exclusion criteria Cardiomyopathy Uncontrolled hypertension History of bariatric surgery HbA1c 9.5% Baseline characteristics Age - 65.3 years Female sex - 53.8% NYHA class: II - 72.5% | III or IV - 27.5% Average body weight - 227 lbs (103 kg) Average BMI - 38.3 Average EF - 60.8% History of CAD - 30% Median NT-proBNP level - 183 pg/ml Average GFR - 64.4 ml/min Average KCCQ-CSS score - 53.6 Heart failure exacerbation within 12 months - 46.9% Atrial fibrillation - 25.5% Type 2 diabetes - 48.2% Randomized treatment groups Group 1 (364 patients): Tirzepatide with a target dose of 15 mg once weekly Group 2 (367 patients): Placebo Tirzepatide was started at 2.5 mg once weekly and increased by 2.5 mg every 4 weeks as tolerated (1) Composite of adjudicated death from cardiovascular causes or a worsening heart-failure event

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Morning administration (69 AM) produces 1822% higher fat oxidation throughout the day by potentiating cortisol-driven lipolytic signaling pathways

Lifestyle Factors That Support Weight Management on Ozempic Optimising lifestyle factors remains fundamental to achieving weight management goals whilst taking Ozempic, as medication alone rarely produces optimal outcomes without supportive behavioural changes