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GLP-1 agonists offer metabolic and anti-inflammatory benefits, but appetite suppression may drive gut microbiome dysbiosis that offsets long-term outcomes.

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Intention-to-treat analyses resulted in an HR of 1.36 (95% CI 0.51, 3.61)

In clinical practice, drug selection should therefore prioritize factors such as tolerability, safety profile, adherence, cost, and patient preference rather than expecting major differences in cardiovascular efficacy.