TOPLINE

Prescription of GLP-1 receptor agonists (GLP-1a) was associated with reduced risk for cardiovascular events in patients with obstructive sleep apnea (OSA), particularly among those not prescribed continuous positive airway pressure (CPAP).

METHODOLOGY

• Researchers conducted a retrospective cohort analysis comparing cardiovascular outcomes between patients with OSA diagnosed between 2014 and 2024 who were prescribed GLP-1a with those who were not. Patients were stratified by use of CPAP and obesity status.
• A total of 133,050 adult patients (≥ 18 years) with OSA were identified from the TriNetX Clinical Trials Network of Tennessee database.
• The included patients were propensity score matched and stratified into the following cohorts: those not prescribed CPAP (n = 5690); those prescribed CPAP (n = 280); those with obesity not prescribed CPAP (n = 2940); and those with obesity who were prescribed CPAP (n = 180).
• Primary outcomes included cardiovascular events, cardiac interventions, and emergency department visits, measured from 1 day to up to 10 years after OSA diagnosis.

TAKEAWAY

• Among patients with OSA not prescribed CPAP, GLP-1a prescription was associated with significantly lower risks for myocardial infarction (rate ratio [RR], 0.650), heart failure (RR, 0.500), cardiac arrest (RR, 0.300), ventricular arrhythmias (RR, 0.385), atrial fibrillation/flutter (RR, 0.833), and percutaneous coronary intervention or coronary artery bypass graft procedures (RR, 0.333).
• Among patients with OSA prescribed CPAP, GLP-1a use was associated with a significantly lower risk for atrial fibrillation/flutter (RR, 0.700), with no other significant differences in cardiovascular outcomes observed.
• In patients with OSA and obesity not prescribed CPAP, GLP-1a prescription was linked to reduced risks for myocardial infarction (RR, 0.727), heart failure (RR, 0.600), cardiac arrest (RR, 0.400), and ventricular arrhythmias (RR, 0.571).
• Among patients with OSA and obesity, those prescribed CPAP and GLP-1a showed significantly lower risk for myocardial infarction (RR, 0.333).

IN PRACTICE

"GLP-1 receptor agonists prescription was associated with improved cardiovascular outcomes in patients with obesity specifically, as well as the full cohort of OSA patients regardless of prescribed CPAP use," wrote the authors of the study.

SOURCE

The study was led by Morgan Lane, University of Tennessee Health Science Center, Memphis. It was published online on July 13 in Laryngoscope Investigative Otolaryngology.

LIMITATIONS

The study could not verify adherence to prescribed therapies or account for alternative OSA treatments such as surgery. Apnea-Hypopnea Index data were unavailable, limiting assessment of disease severity. Weight loss achieved with GLP-1a may serve as a confounder.

DISCLOSURES

The study did not report receiving any specific funding. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.