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Our findings offer comprehensive real-world evidence for the cardiovascular effectiveness of tirzepatide in clinical practice in the absence of studies with direct comparisons to semaglutide, and ahead of further evidence from the SURPASS-CVOT randomized controlled trial that compared tirzepatide against an older GLP-1 receptor agonist that is not frequently used in routine care 14,17

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The dual -amino isobutyric acid strategy demonstrates additive stabilization effects, with the combination providing superior thermal stability and proteolytic resistance compared to single substitutions [4] [5]