Incretin Care in Cardiology: Study Findings

A small retrospective study from one Texas cardiology program suggests that incretin medicines can be managed within cardiovascular care, but it cannot show that the program or a particular drug caused the outcomes it recorded. The study followed 69 patients with follow-up after a prescription for a GLP-1 receptor agonist or a dual GIP/GLP-1 agonist. It reports routine-care data on weight and access, plus medication discontinuation, rather than a randomized comparison.^[1] Readers considering tirzepatide should read this as a description of one clinic's experience, not a treatment plan.

What the cardiology program studied

The clinic began in Austin in September 2023. It combined preventive cardiology visits with nurse follow-up. The program also included dietary counselling. Staff discussed exercise and used portal monitoring. The chart review covered patients with a body-mass index above 30 plus conditions such as type 2 diabetes, coronary artery disease, atrial fibrillation, or heart failure. The authors reviewed prescriptions from September 2023 through July 2025 and collected follow-up data through December 2025.^[2]

This was not a trial that assigned patients to a medicine or to usual care. The team reviewed records from its own service. That design can show how a clinic operated and what happened to the patients it retained. It cannot separate the contribution of medication, coaching, dietary changes, insurance decisions, changing health status, or other treatment changes.^[2]

Who received prescriptions and follow-up

The team sent 142 incretin prescriptions. Seventy-three patients received insurance approval, and 69 had at least one documented follow-up visit and entered the analysis. Their median age was 62 years, and 51% were women. Hypertension, dyslipidaemia, sleep apnea, coronary artery disease, atrial fibrillation, diabetes, and heart failure were common in the cohort. Those details matter because this was a high cardiovascular-risk clinical population, not a general sample of people seeking weight loss.^[2]

Most participants started on semaglutide. Eight of the 69 patients were on tirzepatide at baseline; the rest included smaller numbers receiving dulaglutide or liraglutide. Thirteen patients later changed medicines. Eight moved from semaglutide to tirzepatide, but the paper does not provide a head-to-head estimate that would establish one medicine as better for this group. The article therefore does not replace randomized evidence on either tirzepatide or semaglutide.^[2]

What changed over follow-up

Among patients with available data, median percentage weight loss rose from 6.98% at six months to 9.11% at 12 months, 11.7% after one year, and 13.7% after two years. At 12 months, 30 patients had data available; 75% of that subset had lost at least 5% of baseline weight and 40% had lost at least 10%. The later time points involved fewer people, with only seven patients contributing data beyond two years.^[2]

The paper also reports lower median hemoglobin A1c, LDL cholesterol, triglycerides, and use of antihypertensive medicines at later follow-up. These are observations, not proof that the cardiology program or incretin therapy produced each change. The authors note that background medicines changed during follow-up and that laboratory data were available for only a subset of patients.^[2]

Access and retention were part of the result

Insurance approval narrowed the group before the analysis began: 73 of 142 prescriptions were approved. Five of the 69 included patients stopped therapy completely. The reported reasons were cost for two people, gastrointestinal side effects for two people, and planned bariatric surgery for one person. This is a useful reminder that a prescription alone does not describe access or persistence in routine care.^[2]

The reported discontinuation figure applies to this clinic's analysed group, so it should not be treated as a general rate for all patients using incretin medicines. The study also describes structured contacts around medication initiation and dose escalation. That care model may be relevant to retention, yet the study did not compare it with a different model.^[2]

What we do not yet know

The central limitation is the retrospective, single-centre design without a control group. Attrition makes the later estimates less stable, and the small tirzepatide subgroup does not support drug-specific conclusions. The investigators also could not fully account for changes in statins, antihypertensives, diabetes medicines, or cardiac medicines. Larger comparative research would be needed to test whether cardiology-based programs improve outcomes beyond usual care and which patients benefit most.^[2]

For readers, the practical takeaway is narrower. The paper documents one way a cardiology service incorporated incretin prescribing for patients with substantial cardiometabolic illness. It does not tell an individual which medicine to use, whether to change a current prescription, or how a dose should be managed. Those decisions require a clinician who can review medical history and other medicines, then consider contraindications and local coverage. The study offers no individual eligibility rule. It also cannot establish how its results would translate to clinics with different staffing, insurance systems, patient populations, or follow-up arrangements.^[1]