According to findings, sodium-glucose cotransporter-2 inhibitors (SGLT2I) can prevent the development of adverse cardiovascular events including new-onset heart failure, myocardial infarction, cardiovascular mortality, and all-cause mortality. SGLT2I prescription is favored when individual cardiovascular and metabolic risk profiles are considered in addition to drug–drug interactions.

• In this population-based retrospective cohort study of type 2 diabetes mellitus patients receiving either SGLT2I or dipeptidyl peptidase-4 inhibitors (DPP4I), propensity score matching was conducted and 41,994 patients (58.89% males, median admission age at 58 years old, interquartile range [IQR]: 51.2–65.3) with a median follow-up of 5.6 years (IQR: 5.32–5.82) were included.

• In the matched cohort, lower risks of new-onset heart failure (hazard ratio [HR]: 0.73), myocardial infarction (HR: 0.81), cardiovascular mortality (HR: 0.67), and all-cause mortality (HR: 0.26) were observed in relation to SGLT2I use, post-adjusting for significant demographics, past comorbidities, and non-SGLT2I/DPP4I medications.