{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:21:55Z","timestamp":1789021315946,"version":"build-2803163510"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Clin Sleep Med"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u00a0year 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u00a0years, the GLP-1RA cohort had a significantly lower risk of newly developed heart failure (HR, 0.76; 95% CI, 0.71\u20130.82), pulmonary hypertension (HR, 0.67; 95% CI, 0.59\u20130.75), AMI (HR, 0.76; 95% CI, 0.67\u20130.86), and death from all causes (HR, 0.57; 95% CI, 0.51\u20130.63).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Brief summary<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                    <jats:p>With 3\u00a0years 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s44470-026-00110-x","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T19:51:21Z","timestamp":1782935481000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Glucagon-like peptide receptor agonists (GLP-1RAs) as cardiovascular risk modifiers in obstructive sleep apnea and obesity: a real-world study"],"prefix":"10.1007","volume":"22","author":[{"given":"Jaeun","family":"Ahn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junmin","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Admire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan-Yu","family":"Chi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel T.","family":"Gordon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6642-8953","authenticated-orcid":false,"given":"Joshua M.","family":"Sill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"issue":"15","key":"110_CR1","doi-asserted-by":"publisher","first-page":"1442","DOI":"10.1056\/NEJMcp1816152","volume":"380","author":"SC Veasey","year":"2019","unstructured":"Veasey SC, Rosen IM. Obstructive sleep apnea in adults. N Engl J Med. 2019;380(15):1442\u20139. https:\/\/doi.org\/10.1056\/NEJMcp1816152.","journal-title":"N Engl J Med"},{"issue":"19","key":"110_CR2","doi-asserted-by":"publisher","first-page":"1834","DOI":"10.1056\/NEJMoa1607141","volume":"375","author":"SP Marso","year":"2016","unstructured":"Marso SP, Bain SC, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375(19):1834\u201344. https:\/\/doi.org\/10.1056\/NEJMoa1607141.","journal-title":"N Engl J Med"},{"issue":"13","key":"110_CR3","doi-asserted-by":"publisher","first-page":"1248","DOI":"10.1056\/NEJMcp2000280","volume":"384","author":"RR Kalyani","year":"2021","unstructured":"Kalyani RR. Glucose-lowering drugs to reduce cardiovascular risk in type 2 diabetes. N Engl J Med. 2021;384(13):1248\u201360. https:\/\/doi.org\/10.1056\/NEJMcp2000280.","journal-title":"N Engl J Med"},{"issue":"10193","key":"110_CR4","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/S0140-6736(19)31149-3","volume":"394","author":"HC Gerstein","year":"2019","unstructured":"Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet. 2019;394(10193):121\u201330.\u00a0https:\/\/doi.org\/10.1016\/S0140-6736(19)31149-3.","journal-title":"Lancet"},{"key":"110_CR5","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13082231","author":"C Gu","year":"2024","unstructured":"Gu C, Bernstein N, Mittal N, et al. Potential therapeutic targets in obesity, sleep apnea, diabetes, and fatty liver disease. J Clin Med. 2024. https:\/\/doi.org\/10.3390\/jcm13082231.","journal-title":"J Clin Med"},{"issue":"4","key":"110_CR6","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1056\/NEJMoa1603827","volume":"375","author":"SP Marso","year":"2016","unstructured":"Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375(4):311\u201322.\u00a0https:\/\/doi.org\/10.1056\/NEJMoa1603827.","journal-title":"N Engl J Med"},{"key":"110_CR7","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsaf004","author":"LF Drager","year":"2025","unstructured":"Drager LF. A meta-analysis of glucagon-like peptide 1 receptor and dual agonists for the treatment of obstructive sleep apnea: end of the story or just the beginning? Sleep. 2025. https:\/\/doi.org\/10.1093\/sleep\/zsaf004.","journal-title":"Sleep"},{"key":"110_CR8","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsae280","author":"M Li","year":"2025","unstructured":"Li M, Lin H, Yang Q, et al. Glucagon-like peptide-1 receptor agonists for the treatment of obstructive sleep apnea: a meta-analysis. Sleep. 2025. https:\/\/doi.org\/10.1093\/sleep\/zsae280.","journal-title":"Sleep"},{"issue":"3","key":"110_CR9","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1016\/j.chest.2025.03.030","volume":"168","author":"JY Wu","year":"2025","unstructured":"Wu JY, Chen CC, Ling Tu W, et al. Clinical impact of tirzepatide on patients with OSA and obesity. 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No individual patient-level data were accessed. The study did not require institutional review board approval or informed consent in accordance with the policy of the Institutional Review Board of National Cheng Kung University Hospital.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"102"}}