GLP-1 RA reduced MACE by 14% (P<0.0001), with no significant heterogeneity across GLP-1 RA structural homology or eight other examined subgroups. GLP-1 RA reduced all-cause mortality by 12% (P=0.0001), hospital admission for heart failure by 11% (P=0.013), and the composite kidney outcome by 21% (P<0.0001), with no increase in the risk of severe hypoglycemia, retinopathy, or pancreatic adverse effects. This evidence concerns the gene GLP1R and heart failure.