P1146 - GLP-1 Agonist Use is Associated With Lower Mortality and Improvement of Cardiovascular Outcomes in Patients With Obesity Who Have MAFLD and OSA: A Multi-Center Analysis

Award: Presidential Poster Award

Sharon Narvaez, MD¹, Luis M.. Nieto, MD², Felipe Contreras-Yametti, MD³, Donghyun Ko, MD⁴, Do Han Kim, MD⁵, Treah Haggerty, MD⁶, Laura Davisson, MD⁶, Edward Rojas, MD^7
1Universidad de Guayaquil, School of Medicine, Atlanta, GA; ²Emory University School of Medicine, Atlanta, GA; ³Wellstar Health System - Cobb Medical Center, Atlanta, GA; ⁴Yale-New Haven Health/Bridgeport Hospital, Bridgeport, CT; ⁵Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, NY; ⁶West Virginia University, Morgantown, WV; ⁷West Virginia University School of Medicine, Morgantown, WV

Introduction: Metabolic dysfunction-associated fatty liver disease (MAFLD) affects one in four people globally and is the primary cause of chronic liver disease. Numerous studies have demonstrated that compared to the general population, MAFLD is more common in people with obstructive sleep apnea (OSA). GLP-1 receptor agonists (GLP-1 RAs) have shown promising results in treating MAFLD. Therefore, we aim to evaluate the mortality rate and occurrence of cardiovascular (CV) events in patients with obesity who have MAFLD and OSA.

Methods: We performed a retrospective cohort study utilizing large population-based data from the TriNetX platform. We identified adult patients with obesity (BMI of 30 or greater), OSA and MAFLD who received GLP-1 RAs between January 1, 2019, and April 30, 2024. This cohort of patients was matched with patients who did not receive GLP-1 RAs according to age, demographics, comorbidities, and medication by using 1:1 propensity matching. The primary endpoint was all-cause mortality, and the secondary endpoint were a composite of CV events and CPAP/BiPAP use. Logistic regression was used to estimate odd ratios (ORs).

Results: A total of 60,258 adult patients with obesity along with MAFLD and OSA were identified, 17,112 of these individuals were taking GLP -1 RAs; 13,711 out of 17,112 (mean [SD] age, 54 [12.5] years; 7,174 [52.3%] female) were matched with 13,711 individuals (mean [SD] age, 54 [14.1] years; 7,243 [52.8%] female) who did not take GLP-1 RAs. The GLP-1 RAs group had significant lower odds of all-cause mortality (Odds Ratio [OR], 0.41; 95% Confidence Interval [CI], 0.34-0.49) and CV events including heart failure (OR, 0.55; 95% CI, 0.46-0.65), acute myocardial infarction (OR, 0.55; 95% CI, 0.43-0.71), HTN (OR, 0.69; 95% CI, 0.56-0.84) and cerebrovascular disease (OR, 0.59; 95% CI, 0.49-0.70) compared with the non-GLP-1 RAs group. Less use of CPAP/BiPAP was found in the GLP-1 RAs group; (OR, 0.84; 95% CI, 0.78-0.90) and (OR, 0.85; 95% CI, 0.79-0.91) respectively. No significant reductions in coronary revascularization (OR, 0.49; 95% CI, 0.04-5.46) and unstable angina (OR, 1.14; 95% CI, 1.02-1.27) were identified.

Discussion: In this multicenter retrospective study, we found that patients with obesity and associated MAFLD and OSA who are on GLP-1 RAs have reduced rates of all-cause mortality, major CV events and less use of CPAP/BiPAP. Further prospective studies are needed to determine the mechanism for these clinical findings.


Disclosures:


Sharon Narvaez, MD¹, Luis M.. Nieto, MD², Felipe Contreras-Yametti, MD³, Donghyun Ko, MD⁴, Do Han Kim, MD⁵, Treah Haggerty, MD⁶, Laura Davisson, MD⁶, Edward Rojas, MD⁷. P1146 - GLP-1 Agonist Use is Associated With Lower Mortality and Improvement of Cardiovascular Outcomes in Patients With Obesity Who Have MAFLD and OSA: A Multi-Center Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.