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About The Study: In this study, major adverse cardiovascular event risk varied significantly by medication class, with most protection achieved with sustained treatment with glucagon-like peptide-1 receptor agonists (GLP-1RAs) followed by sodium-glucose cotransporter-2 inhibitors (SGLT2is), sulfonylureas, and dipeptidyl peptidase-4 inhibitors. The magnitude of benefit of GLP-1RAs over SGLT2is depended on baseline age, atherosclerotic cardiovascular disease, heart failure, and kidney impairment. These results, along with consideration of cost, availability, and collateral clinical benefits, may inform treatment decisions for adults with type 2 diabetes.