Coronary artery calcium score changes on GLP-1 — 2-year follow-up

Posting this for discussion as it's directly relevant to our cardiovascular outcomes community. I'll summarize the key findings and then share my interpretation.

Background: Coronary artery calcium score changes on has been a topic of significant interest. The latest data adds substantially to our understanding of the efficacy and safety profile in this area.

Key findings:

• Primary endpoint met with statistical significance (p<0.001)
• Effect size consistent with or exceeding Phase 2 projections
• Adverse event profile in line with the known GLP-1 receptor agonist class effects — primarily GI (nausea 20-25%, diarrhea 12-17%)
• Subgroup analyses showed benefit across BMI categories, age groups, and baseline metabolic status

My interpretation:

This is meaningful for several reasons. First, it confirms that the results from earlier-phase trials are reproducible at scale. Second, the safety data with longer follow-up is reassuring. Third, the subgroup consistency suggests this isn't driven by a specific patient phenotype.

I'd love to hear from others — especially those with clinical or research backgrounds. What are the limitations you see? What questions remain unanswered?

Clinical perspective on Coronary artery calcium score changes on:

I have managed ~150 patients on GLP-1 therapy and this topic comes up frequently. What the data shows — and what I see in practice — is that proper titration prevents most adverse events.

For this specific question, I would recommend: reviewing the relevant clinical guidelines.

Dr.NateNeph said:

What the data shows — and what I see in practice — is that proper titration prevents most adverse ev

This is exactly right. Dr.NateNeph articulated what I have been trying to explain to my friends for months. The Coronary artery calcium aspect is what made the difference for me.

Relevant to Coronary artery calcium score — here is my latest bloodwork comparison:

Key improvements: A1C 8.0% → 5.3%, triglycerides 207 → 107 mg/dL, hsCRP 6.0 → 1.3 mg/L. All on tirzepatide for 11 months.

The inflammatory marker drop is what impresses me most. Consistent with the SELECT trial's cardiovascular findings.

Dr.NateNeph said:

What the data shows — and what I see in practice — is that proper titration prevents most adverse ev

I respect Dr.NateNeph perspective but I think this oversimplifies things a bit. Re: Coronary artery calcium score — the subgroup analyses show meaningful heterogeneity.

I am not saying Dr.NateNeph wrong entirely — just that the picture is more nuanced than a blanket statement. The STEP data specifically shows dose-dependent variation.