In obese patients with obstructive sleep apnea, GLP-1RA use was associated with a lower risk of newly developed heart failure (HR 0.76; 95% CI 0.71-0.82) compared to non-use over 3 years.
Cohort (n=865,911)
Do GLP-1 receptor agonists reduce the risk of newly diagnosed heart failure and other cardiovascular events in obese patients with obstructive sleep apnea?
In obese patients with obstructive sleep apnea, GLP-1RA use is associated with significantly reduced risks of incident heart failure, pulmonary hypertension, acute myocardial infarction, and all-cause mortality.
Hazard Ratio: 0.76 (95% CI 0.71–0.82)
Abstract Introduction Obstructive sleep apnea (OSA) is a well-established risk factor for cardiovascular disease. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated potential in reducing cardiovascular risk and improving OSA severity. However, a significant knowledge gap remains regarding the impact of GLP-1RAs on cardiovascular events in OSA patients. Methods We examined patients with a BMI over 30 diagnosed with OSA between January 2010 and November 2021 without a previous diagnosis of heart failure, pulmonary hypertension, or myocardial infarction. Two cohorts were created: those prescribed GLP-1RAs within 1 year of their OSA diagnosis and patients who were never prescribed GLP-1RAs. Propensity score matching was performed using TriNetX software with greedy nearest neighbor methodology. Cox proportional hazards analyses were conducted over a 3-year follow-up period. The primary outcome was newly diagnosed heart failure. Secondary outcomes included pulmonary hypertension, death from all causes, ischemic stroke, and acute myocardial infarction (AMI). Results We included 18,774 patients in the GLP-1RA cohort and 847,137 patients in the non-GLP-1RA cohort. Propensity score matching resulted in 18,523 patients remaining in each cohort, which were well-matched in demographics, comorbidities, medications, BMI, and HbA1c. After 3 years, the GLP-1RA cohort had a significantly lower risk of newly developed heart failure (HR, 0.76; 95% CI, 0.71–0.82), pulmonary hypertension (HR, 0.67; 95% CI, 0.59–0.75), AMI (HR, 0.76; 95% CI, 0.67–0.86), and death from all causes (HR, 0.57; 95% CI, 0.51–0.63). Conclusion GLP-1RAs were associated with reduced risks of heart failure, pulmonary hypertension, AMI, and death from all causes in obese OSA patients. Prospective studies are needed for validation. Brief summary GLP-1 receptor agonists (GLP-1RAs) have shown promising potential in reducing cardiovascular risk and alleviating the severity of obstructive sleep apnea (OSA), a well-known risk factor for cardiovascular disease. However, a significant knowledge gap remains regarding the impact of GLP-1RAs on cardiovascular events specifically in patients with OSA. With 3 years of follow-up, the GLP-1RAs reduced newly developed heart failure by 24%, pulmonary hypertension by 33%, acute myocardial infarction by 24%, and death by 43%, with notable early separation in heart failure and all-cause mortality. This finding supports the potential for broader use of GLP-1RAs in this population, not only to improve OSA severity, but also to reduce cardiovascular risk.
Ahn et al. (Wed,) conducted a cohort in Obstructive sleep apnea and obesity (n=865,911). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) vs. Never prescribed GLP-1RAs was evaluated on Newly diagnosed heart failure (HR 0.76, 95% CI 0.71-0.82). In obese patients with obstructive sleep apnea, GLP-1RA use was associated with a lower risk of newly developed heart failure (HR 0.76; 95% CI 0.71-0.82) compared to non-use over 3 years.