Key result
GLP-1 agonists linked to ~35% lower MI risk in OSA patients not using CPAP.
Why the study?
OSA is highly associated with obesity and often results in significant cardiovascular complications, prompting evaluation of cardiovascular outcomes with GLP-1 agonists versus CPAP.
Does GLP-1 agonist prescription reduce cardiovascular events in adult patients with obstructive sleep apnea?
Cohort (n=18,180)
Yes
Does GLP-1 agonist prescription reduce cardiovascular events in adult patients with obstructive sleep apnea?
GLP-1 receptor agonist prescription is associated with a significantly reduced risk of major cardiovascular events in patients with obstructive sleep apnea, particularly those not on CPAP therapy.
Answers are grounded in this paper and cite their sources.
May support GLP-1 agonists in CPAP-intolerant OSA; extends observational data but leaves open confirmation in RCTs.
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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Lane et al. (2026) conducted a cohort in Obstructive sleep apnea (OSA) (n=18,180). GLP-1 agonists vs. No GLP-1 agonist prescription was evaluated on Myocardial infarction (in the non-CPAP cohort) (RR 0.650, 95% CI 0.523-0.808, p=<0.001). In OSA patients not using CPAP, GLP-1 agonist prescription was associated with a 35% reduced risk of myocardial infarction (RR 0.650) and decreased risks of other major cardiovascular events compared to non-users.
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