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Cardio-Protective Effect of GLP-1 Agonists in OSA Patients: A Study of Cardiovascular Risk
Morgan Lane1, Alex Jin1, Boston Andersen1
1University of Tennessee Health Science Center College of Medicine Memphis Tennessee USA.
Objective:
Obstructive sleep apnea (OSA) is highly associated with obesity and often results in significant cardiovascular complications. This study aimed to assess cardiovascular outcomes in OSA patients treated with GLP-1 agonists (GLP1a) versus CPAP.
Methods:
This retrospective cohort analysis using TriNetX datasets (2014-2024) compared cardiovascular outcomes between four pairs of cohorts, after propensity score matching (PSM): OSA+CPAP +/- GLP1a, OSA+Obesity + CPAP +/- GLP1a, OSA-CPAP +/- GLP1a, and OSA+Obesity-CPAP +/- GLP1a. Outcomes of interest include myocardial infarction, heart failure, stroke, cardiac arrest, ventricular arrhythmias, atrial fibrillation/flutter, pulmonary hypertension, and percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG).
Results:
In the non-CPAP cohort, GLP-1a therapy showed decreased risks of myocardial infarction (RR 0.650 [0.523-0.808]), heart failure (RR 0.500 [0.357-0.701]), cardiac arrest (RR 0.300 [0.199-0.450]), ventricular arrhythmias (RR 0.385 [0.278-0.532]), atrial fibrillation/flutter (RR 0.833 [0.762-0.912]), and PCI/CABG (RR 0.333 [0.163-0.681]). No significant differences were observed in stroke or pulmonary hypertension between GLP1+ and GLP1- groups in this cohort. Among patients using CPAP, GLP1a use was associated with a decreased risk of atrial fibrillation/flutter (RR 0.700 [0.542-0.905]), with no other differences observed.
Conclusion:
Our study indicates that GLP-1 agonists may offer cardioprotective benefits not achieved with CPAP therapy in OSA patients. Our study indicates that a GLP-1 agonist prescription may be associated with improved cardiovascular outcomes; these associations were not observed with CPAP therapy prescription in OSA patients. Additional research is required to determine whether obesity status modulates the observed benefits among patients with OSA.
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