Comparative Study of Tirzepatide Versus Dulaglutide (SURPASS CVOT) or Semaglutide on Major Cardiovascular Events in Participants With Type 2 Diabetes

Inclusion Criteria: * Patients with T2D who were new users of tirzepatide or new users of dulaglutide * AND established ASCVD defined as: * History of Myocardial Infarction (MI) or MI sequela * Unstable or stable angina * Coronary atherosclerosis disease or procedures * Ischemic stroke * Peripheral arterial disease or procedures * Atherosclerotic cerebrovascular disease or cerebrovascular procedures * Lower-limb amputation * Age \>= 40 years old * Patients with at least 180 days of continuous health plan enrollment before and including the treatment initiation date Exclusion Criteria: * Patients with Type 1 diabetes mellitus * Patients with missing age or sex information * Patients with history of proliferative diabetic retinopathy, panretinal photocoagulation, vitreous hemorrhage, or intravitreal anti-VEGF injection * Patient within history of left ventricular assisted device (LVAD) or heart transplant * Patients with any previous organ transplants * Patients with acute of chronic pancreatitis * Patients with gastroparesis, bowel obstruction or bariatric surgery * Patient with CKD Stage 5, end stage kidney disease, kidney transplant, or hemodialysis * Patients with multiple endocrine neoplasm syndrome type 2 (MEN-2) * Patient with cancer * Pregnant women * Patient with diabetic ketoacidosis or HONK within the last year to treatment initiation * Patients with acute hepatitis within the last year to treatment initiation * Patients with elevated serum calcitonin level within the last year to treatment initiation * Previous exposure to GLP-1RA or pramlintide during the 180-days washout period and including treatment initiation date * Patients with severe hypoglycemia within the last 6 months to treatment initiation * Patients with hospitalization for heart failure within the last 60 days to treatment initiation * Patient with acute coronary syndrome, ischemic stroke, peripheral arterial disease, or coronary or cerebrovascular procedure within the last 60 days to treatment initiation * Patients with prescription dispensing for both tirzepatide and dulaglutide on treatment initiation date