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Article History

Received: 24 February 2026

Accepted: 30 April 2026

First Online: 12 June 2026

Declarations

:

: Oral and written informed consent were obtained from all participants. The trial was approved by The Regional Committee on Health Research Ethics (no. S-20210028) in the Southern Denmark Region and the Danish Medicines Agency (no. 2021040401). Trial conduct was in alignment with the Danish Health Act, the Declaration of Helsinki, and the standards for Good Clinical Practice.

: All authors take full responsibility for the data in this manuscript and have consented to publication.

: C.F.A. reports grants from Danish Heart Foundation, Toyota-Fonden, Arvid Nilsson’s Foundation, Aase & Ejnar Danielsen’s Foundation, Fru Asta Florida Bolding’s Memorial Grant, KV Foundation and The Research and Innovation Foundation of the Department of Cardiology (FUHAS, formerly FUKAP), Herlev and Gentofte University Hospital, Herlev, Denmark, during the conduct of the submitted work; personal fees from AstraZeneca and has acted as an unpaid sub-investigator in two trials from Novo Nordisk, outside the submitted work. J.H.L. reports grants from Danish Heart Foundation, Odense University Hospital Ph.D. Foundation, Steno Diabetes Center Odense Ph.D. Foundation, Eva and Henry Frænkel’s Memorial Grant, Kurt and Grethe Bønnelykke’s Foundation, Guldsmed A.L. Rasmussen’s Memorial Grant. M.A.O reports grants from the Danish Heart Foundation; The Steno Diabetes Center Odense, Denmark; and the A.P. Møller Foundation, outside the submitted work. N.N. reports speaker fees from AstraZeneca and Bayer, all outside the submitted work. C.K. has received speaker fees or served on advisory boards for AstraZeneca, Boehringer Ingelheim, Novartis Genzyme, Amicus and Chiesi. C.T. reports speaker fees from Orion Pharma, personal fees for advisory board participation from Boehringer Ingelheim and Bayer A/S, all outside the submitted work. F.K.K. has previously served on scientific advisory panels and/or been part of speaker’s bureaus for, served as a consultant to and/or received research support from 89bio, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Carmot Therapeutics, Eli Lilly, Gubra, Lupin, MedImmune, MSD/Merck, Mundipharma, Norgine, Novo Nordisk, Pharmacosmos, Sanofi, Structure Therapeutics, Zealand Pharma and Zucara; is a co-founder and minority shareholder in Antag Therapeutics; and currently employed by Novo Nordisk. F.S.D reports grants from The CARDIOHGH at the Department of Cardiology, Herlev and Gentofte University Hospital, the Novo Nordisk Foundation and speaker fees from Bayer, all outside the submitted work. L.K. reports speaker fees from AstraZeneca, Boehringer Ingelheim, Novartis and Bayer. K.H. reports grants from the Novo Nordisk Foundation, the Independent Research Fund Denmark, the Region of Southern Denmark, Odense University Hospital, Lilly and Herbert Hansen’s Foundation, Jascha Fonden, the Ministry of Higher Education and Science, and the Danish Diabetes Academy all outside submitted work. M.S. reports grants from The Danish Heart Foundation, during the conduct of the study; personal fees and non-financial support from AstraZeneca, personal fees from Novo Nordisk and Boehringer Ingelheim, outside the submitted work. J.E.M. reports speaker fees from Novartis, Boehringer Ingelheim, Abiomed, Orion and Abbott, advisory board from Orion and Boehringer Ingelheim, and research grant Abiomed and Roche, all outside submitted work. J.J. reports grants from The Capital Region of Denmark; Novo Nordisk (speaker fee), Roche Diagnostics (conference participation) Boehringer Ingelheim (contribution to the KARDINAL study), Bayer (member of the steering committee of the ALPINE 1 trial), all outside the submitted work.