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Glucagon-like peptide 1 receptor agonists (GLP-1RAs) improve glycaemic control,1 promote weight loss,2 delay progression of kidney disease,3 and reduce major adverse cardiovascular events (including myocardial infarction and stroke)4–6 in people with type 2 diabetes mellitus. The expanding indications of GLP-1RAs—including for individuals with obesity but who do not have diabetes—have driven rapid global uptake.7 However, discontinuation is common, with studies reporting that up to half of patients stop treatment with a GLP-1RA within the first year.8 9 Although previous evidence suggests that interruption or discontinuation of GLP-1RAs may diminish or reverse their beneficial cardiometabolic effects,10 the impact on major adverse cardiovascular events has remained uncertain.