The study was designed using the PICO model [8]: population (adults with T2DM and ASCVD, CKD, or HF), intervention (GLP-1 RAs including semaglutide and exenatide), comparator (placebo or standard care), and outcomes (CV-related outcomes such as MACE, CV mortality, HF hospitalization, and surrogate markers, e.g., NT-proBNP and NYHA class). Here, NPPB is linked to hydrops fetalis.