Our larger study found protective effects of SGLT-2 inhibitors for heart failure compared with DPP-4 inhibitors, similar to meta-analyses of randomised controlled trials 86, 87 and observational studies.32 However, even with this relatively large sample, the number of people followed over the full follow-up period was insufficient to detect other clinically important differences for outcomes such as major adverse kidney events, and to investigate end stage kidney disease and CVD specific mortality individually. Here, DPP4 is linked to heart failure.