In the propensity score-matched cohort comparing GLP-1 RAs with DPP-4 inhibitors, GLP-1 RA treatment was significantly associated with a lower risk of MACE [aHR 0.52, 95% CI 0.46–0.58; RR 0.54, 95% CI 0.49–0.61, corresponding to a 46% risk reduction], as well as hospitalizations for coronary artery disease (aHR 0.64, 95% CI 0.54–0.75), stroke (aHR 0.48, 95% CI 0.40–0.56), and heart failure (aHR 0.33, 95% CI 0.25–0.42). Here, DPP4 is linked to heart failure.