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The DOI matches its Crossref record; 6 of the 6 references it cites were found in a registry or an index; 4 of the 12 sources its claims cite were checked for support.

GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

Open access
Shah, Stuti, Abusafia, Mohammed, Sheashaa, Hesham, Jadam, Shada, Ospina, Susan, Kaelber, David, Keen, Susan K., Desai, Milind Y.·2026·JACC: Advances
DOI 10.1016/j.jacadv.2026.102955PMC PMC13699703
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Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In a propensity-matched TriNetX cohort of adults with hypertrophic cardiomyopathy (HCM) and obstructive sleep apnea (OSA), GLP-1 receptor agonist (GLP-1 RA) exposure was associated with lower major adverse cardiovascular events (MACE) and all-cause mortality. The association was observational and hypothesis-generating, with no significant differences in myocardial infarction, ischemic stroke, acute heart failure hospitalization, or arrhythmic events.

Key findings

  • After 1:1 propensity matching, there were 5,372 patients in each cohort; median follow-up was 677 days (IQR: 1,016) in the GLP-1 RA cohort and 505 days (IQR: 858) in the comparator cohort.
  • GLP-1 RA exposure was associated with lower cumulative MACE risk (12.2% vs 16.8%; OR: 0.689; P < 0.001) and favorable time-to-event analysis (HR: 0.700; 95% CI: 0.645-0.761; log-rank P < 0.001), with MACE-free survival at 3,650 days of 51.86% vs 38.11%.
  • The MACE difference was primarily driven by lower mortality in the GLP-1 RA group (8.7% vs 14.2%; OR: 0.579; P < 0.001; HR: 0.534; 95% CI: 0.476-0.600; log-rank P < 0.001).
  • No significant differences were found for MI (6.6% vs 7.7%; OR: 0.854; P = 0.06), ischemic stroke (0.3% vs 0.3%; OR: 1.060; P = 0.868), acute heart failure hospitalization (8.5% vs 9.2%; OR: 0.916; P = 0.197), or arrhythmic events (14.6% vs 13.0%; OR: 1.142; P = 0.061).

Methods

  • Observational cohort study using the TriNetX Global Collaborative Network; adults ≥18 years with HCM (ICD-10 I42.1/I42.2) and OSA (ICD-10 G47.33) were identified, excluding patients with prior heart transplant, septal reduction therapy, or myectomy.
  • Exposure was GLP-1 RA use on or after December 24, 2014, after initial HCM diagnosis, versus no GLP-1 RA exposure; 1:1 propensity score matching included demographics, cardiovascular and metabolic comorbidities, medication use, and laboratory variables.
  • Primary outcome was MACE, defined as a composite of all-cause mortality, acute MI, and ischemic stroke; secondary outcomes were acute heart failure hospitalization and arrhythmias; results reported as cumulative risks (ORs) and time-to-event associations (HRs with log-rank), with outcomes assessed from day 1 after cohort entry through up to 3,650 days.

Limitations

  • The paper states that the study is observational and cannot establish causality; residual confounding may exist because HCM phenotype/severity, OSA severity, continuous positive airway pressure adherence, longitudinal weight change, socioeconomic factors, and care intensity were not captured.
  • The paper also states diagnostic/outcome miscoding or misclassification may occur, out-of-network events were missed, arrhythmic outcomes relied on diagnostic coding without standardized rhythm monitoring or adjudication, medication exposure did not reflect dose/duration/persistence/adherence, baseline medication differences may introduce treatment intensity bias, multiple GLP-1 RA agents and evolving prescribing patterns may introduce heterogeneity, and residual immortal time bias cannot be fully excluded.
  • The text makes evident that quantitative sleep metrics (e.g., hypoxic burden) and OSA treatment adherence were unavailable, so mediation through sleep-disordered breathing cannot be determined; MI interpretation should remain cautious because biomarker elevation may occur without obstructive coronary disease.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.jacadv.2026.102955

Cites

6 of 6 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

4 of 12 cited sources checked · 3 supported · 0 flagged · accuracy not yet measured

  • Findingown data
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Time-to-event analysis favored GLP-1 RA exposure for MACE (HR: 0.700; 95% CI: 0.645-0.761; log-rank P < 0.001).

    “Time-to-event analysis similarly favored GLP-1 RA exposure (HR: 0.700; 95% CI: 0.645-0.761; log-rank P < 0.001)”
    Quote in the paperSubstantial claim
    • Rests on an assumption: ICD-10 codes accurately identify HCM and OSA in the TriNetX database.
    • Rests on an assumption: Propensity score matching on measured covariates sufficiently controls confounding to allow the observed associations to be interpreted as approximate effects of GLP-1 RA exposure.
    • Rests on an assumption: GLP-1 RA exposure as recorded in the database reflects actual use.
  • Findingown data
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Cumulative incidence of acute heart failure hospitalization was not significantly different between GLP-1 RA and no GLP-1 RA groups (8.5% vs 9.2%; OR: 0.916; P = 0.197).

    “Cumulative incidence of MI (6.6% vs 7.7%; OR 0.854; P = 0.06), ischemic stroke (0.3% vs 0.3%; OR: 1.060; P = 0.868), acute heart failure hospitalization (8.5% vs 9.2%; OR: 0.916; P = 0.197), or arrhythmic events (14.6% vs 13.0%; OR: 1.142; P = 0.061) were not significantly different between GLP-1 RA vs no GLP-1 RA groups, respectively.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: ICD-10 codes accurately identify HCM and OSA in the TriNetX database.
    • Rests on an assumption: Propensity score matching on measured covariates sufficiently controls confounding to allow the observed associations to be interpreted as approximate effects of GLP-1 RA exposure.
    • Rests on an assumption: GLP-1 RA exposure as recorded in the database reflects actual use.
  • Findingown data
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Cumulative incidence of arrhythmic events was not significantly different between GLP-1 RA and no GLP-1 RA groups (14.6% vs 13.0%; OR: 1.142; P = 0.061).

    “Cumulative incidence of MI (6.6% vs 7.7%; OR 0.854; P = 0.06), ischemic stroke (0.3% vs 0.3%; OR: 1.060; P = 0.868), acute heart failure hospitalization (8.5% vs 9.2%; OR: 0.916; P = 0.197), or arrhythmic events (14.6% vs 13.0%; OR: 1.142; P = 0.061) were not significantly different between GLP-1 RA vs no GLP-1 RA groups, respectively.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: ICD-10 codes accurately identify HCM and OSA in the TriNetX database.
    • Rests on an assumption: Propensity score matching on measured covariates sufficiently controls confounding to allow the observed associations to be interpreted as approximate effects of GLP-1 RA exposure.
    • Rests on an assumption: GLP-1 RA exposure as recorded in the database reflects actual use.
  • Findingown data
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Cumulative incidence of myocardial infarction was not significantly different between GLP-1 RA and no GLP-1 RA groups (6.6% vs 7.7%; OR 0.854; P = 0.06).

    “Cumulative incidence of MI (6.6% vs 7.7%; OR 0.854; P = 0.06), ischemic stroke (0.3% vs 0.3%; OR: 1.060; P = 0.868), acute heart failure hospitalization (8.5% vs 9.2%; OR: 0.916; P = 0.197), or arrhythmic events (14.6% vs 13.0%; OR: 1.142; P = 0.061) were not significantly different between GLP-1 RA vs no GLP-1 RA groups, respectively.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: ICD-10 codes accurately identify HCM and OSA in the TriNetX database.
    • Rests on an assumption: Propensity score matching on measured covariates sufficiently controls confounding to allow the observed associations to be interpreted as approximate effects of GLP-1 RA exposure.
    • Rests on an assumption: GLP-1 RA exposure as recorded in the database reflects actual use.
  • Findingown data
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    GLP-1 RA exposure was associated with lower all-cause mortality (8.7% vs 14.2%; OR: 0.579; P < 0.001; HR: 0.534; 95% CI: 0.476-0.600; log-rank P < 0.001).

    “Analysis of individual MACE components showed that this difference was primarily driven by lower mortality in the GLP-1 RA group (8.7% vs 14.2%; OR: 0.579; P < 0.001; HR: 0.534; 95% CI: 0.476-0.600; log-rank P < 0.001).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: ICD-10 codes accurately identify HCM and OSA in the TriNetX database.
    • Rests on an assumption: Propensity score matching on measured covariates sufficiently controls confounding to allow the observed associations to be interpreted as approximate effects of GLP-1 RA exposure.
    • Rests on an assumption: GLP-1 RA exposure as recorded in the database reflects actual use.
  • Probably not a substantial claim. 19
  • It may state two separate claims as one. 12

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Contemporary guidelines recommend assessment for symptoms of sleep-disordered breathing and OSA with referral for evaluation and treatment when present.

    “contemporary guidelines now recommend assessment for symptoms of sleep-disordered breathing and OSA with referral for evaluation and treatment when present.1”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [1] Ommen, 2020, 2020 AHA/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines, J Am Coll Cardiol source

      Section 9.4 (Comorbidities; page unavailable) says sleep-disordered breathing is common in patients with HCM and discusses diagnosis and treatment of obstructive sleep apnea. A reference cross-link in that section also contains the fragment “specialist for evaluation and treatment.” The available passages do not show the specific recommendation to assess symptoms and refer patients when symptoms are present. (LLM, conf=0.78)

      Experimental — accuracy not yet measured

  • It may state two separate claims as one.

    Premisecitation
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Incretin-based therapy is accompanied by reductions in body weight and systolic blood pressure, which may contribute to lower overall cardiovascular risk.

    “This is accompanied by reductions in body weight and systolic blood pressure, which may contribute to lower overall cardiovascular risk.5”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [5] Malhotra, 2024, Tirzepatide for the treatment of obstructive sleep apnea and obesity, N Engl J Med source

  • It may state two separate claims as one.

    Premisecitation
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Incretin-based therapy can improve OSA severity and cardiometabolic risk factors in obesity-related OSA.

    “incretin-based therapy can improve OSA severity and cardiometabolic risk factors in obesity-related OSA.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [5] Malhotra, 2024, Tirzepatide for the treatment of obstructive sleep apnea and obesity, N Engl J Med source

  • It may state two separate claims as one.

    Premisecitation
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Incretin-based therapy (tirzepatide) reduces OSA severity along with body weight and blood pressure in patients with obesity and OSA.

    “incretin-based therapy (tirzepatide) has been shown to reduce OSA severity along with body weight and blood pressure in patients with obesity and OSA.5”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [5] Malhotra, 2024, Tirzepatide for the treatment of obstructive sleep apnea and obesity, N Engl J Med source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Findingown data
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Median follow-up after matching was 677 days (IQR: 1,016) in the GLP-1 RA cohort and 505 days (IQR: 858) in the comparator cohort.

    “The median follow-up after matching was 677 days (IQR: 1,016) in the GLP-1 RA cohort and 505 days (IQR: 858) in the comparator cohort.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: ICD-10 codes accurately identify HCM and OSA in the TriNetX database.

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Before matching, cohort sizes were 5,435 in the GLP-1 RA group and 38,383 in the no GLP-1 RA group.

    “Before matching, cohort sizes were 5,435 (GLP-1 RA) and 38,383 (no GLP-1 RA), respectively.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: ICD-10 codes accurately identify HCM and OSA in the TriNetX database.

  • Probably not a substantial claim.

    Findingown data
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    After propensity matching, 5,372 patients were included in each cohort.

    “After propensity matching, 5,372 patients were included in each cohort.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: ICD-10 codes accurately identify HCM and OSA in the TriNetX database.
    • Rests on an assumption: Propensity score matching on measured covariates sufficiently controls confounding to allow the observed associations to be interpreted as approximate effects of GLP-1 RA exposure.

  • Probably not a substantial claim. It may state two separate claims as one.

    Study design and conductreasoning
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    To reduce immortal time bias, the analysis was restricted to patients identified from 2014 onward, exposure was modeled as a fixed variable from the index date, and outcome assessment began 1 day after cohort entry.

    “To reduce immortal time bias, we restricted the analysis to patients identified from 2014 onward, modeled exposure as a fixed variable from the index date, and began outcome assessment 1 day after cohort entry.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Study design and conductreasoning
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Differences in baseline medication use may reflect greater underlying HCM, OSA, or overall cardiometabolic disease severity, introducing treatment intensity bias.

    “Differences in baseline medication use may also reflect greater underlying HCM, OSA, or overall cardiometabolic disease severity, introducing treatment intensity bias.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Premisecitation
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    In a contemporary cohort evaluated by polysomnography, OSA was frequent and associated with adverse structural and physiologic indices, including higher left ventricular mass index and worse diastolic parameters.

    “In a contemporary cohort evaluated by polysomnography, OSA was frequent and associated with adverse structural and physiologic indices (including higher left ventricular mass index and worse diastolic parameters).2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] Karim, 2025, Prevalence and clinical implications of sleep apnea in hypertrophic cardiomyopathy, JAMA Cardiol source

      Checked before — its earlier verdict is held back until a new check runs.

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Study design and conductnone given
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Prescribing patterns evolved during the study period as GLP-1 RA indications expanded from primarily diabetes management to include weight management and cardiovascular risk reduction in selected patients.

    “Prescribing patterns also evolved during the study period as GLP-1 RA indications expanded from primarily diabetes management to include weight management and cardiovascular risk reduction in selected patients.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Fath et al reported lower all-cause mortality and lower heart failure hospitalization among patients with obesity and HCM receiving GLP-1 RA therapy.

    “Fath et al6 reported lower all-cause mortality and lower heart failure hospitalization among patients with obesity and HCM receiving GLP-1 RA therapy”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Fath, 2025, Cardiovascular outcomes of glucagon-like peptide-1 agonist in patients with obesity and hypertrophic cardiomyopathy, Int J Cardiol source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductnone given
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Medication exposure may not reflect dose, duration, persistence, switching, or adherence.

    “Medication exposure may not reflect dose, duration, persistence, switching, or adherence.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductnone given
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    The study period spans multiple GLP-1 RA agents with differing efficacy profiles, which may introduce treatment heterogeneity not captured in this analysis.

    “In addition, the study period spans multiple GLP-1 RA agents with differing efficacy profiles, which may introduce treatment heterogeneity not captured in this analysis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Study design and conductreasoning
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Direct comparison with the present study should be cautious because the present cohort specifically required concomitant OSA, did not require obesity, and differed in cohort construction, exclusion criteria, and covariate selection.

    “direct comparison with the present study should be cautious because our cohort specifically required concomitant OSA, did not require obesity, and differed in cohort construction, exclusion criteria, and covariate selection.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    In obstructive HCM, greater severity of OSA is associated with a higher prevalence of nonsustained ventricular tachycardia.

    “In obstructive HCM, greater severity of OSA has also been associated with a higher prevalence of nonsustained ventricular tachycardia.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] Wang, 2019, Obstructive sleep apnea is associated with nonsustained ventricular tachycardia in patients with hypertrophic obstructive cardiomyopathy, Heart Rhythm source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Study design and conductreasoning
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Diagnostic and outcome miscoding/misclassification may occur across heterogeneous health systems, and events outside the network were missed.

    “Diagnostic and outcome miscoding/misclassification may occur across heterogeneous health systems, and events outside the network were missed.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim.

    Study design and conductown data
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Propensity score matching (1:1) was performed across clinically relevant covariates, including demographics, specific cardiovascular and metabolic comorbidities, medication use, and laboratory variables.

    “Propensity score matching (1:1) was performed across clinically relevant covariates (including demographics, specific cardiovascular and metabolic comorbidities, medication use, and laboratory variables) as shown in Figure 1A.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. It may state two separate claims as one.

    Study design and conductreasoning
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    The study is observational; thus, findings reflect associations and cannot establish causality.

    “The study is observational; thus, findings reflect associations and cannot establish causality.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    HCM cohorts with sleep-disordered breathing demonstrate adverse structural and physiologic features, including worse diastolic indices and higher left ventricular mass index.

    “HCM cohorts with sleep-disordered breathing demonstrate adverse structural and physiologic features, including worse diastolic indices and higher left ventricular mass index.2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [2] Karim, 2025, Prevalence and clinical implications of sleep apnea in hypertrophic cardiomyopathy, JAMA Cardiol source

      Checked before — its earlier verdict is held back until a new check runs.

  • Probably not a substantial claim.

    Study design and conductnone given
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Arrhythmic outcomes were identified using diagnostic coding without standardized rhythm monitoring, ambulatory monitoring duration, device interrogation, or adjudicated arrhythmic burden.

    “Arrhythmic outcomes were identified using diagnostic coding without standardized rhythm monitoring, ambulatory monitoring duration, device interrogation, or adjudicated arrhythmic burden.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Study design and conductown data
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Important disease-specific variables, including HCM phenotype, OSA severity, continuous positive airway pressure adherence, longitudinal weight change, and socioeconomic factors, were not consistently available and therefore could not be incorporated into matching.

    “Important disease-specific variables, including HCM phenotype (obstructive vs nonobstructive), OSA severity, continuous positive airway pressure adherence, longitudinal weight change, and socioeconomic factors, were not consistently available and therefore could not be incorporated into matching.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductreasoning
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    The retrospective design and exposure timing may introduce time-related biases.

    “Finally, the retrospective design and exposure timing may introduce time-related biases.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation
    § GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea

    Sleep-disordered breathing and obstructive sleep apnea (OSA) are common in hypertrophic cardiomyopathy (HCM).

    “Sleep-disordered breathing and obstructive sleep apnea (OSA) are common in HCM.1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] Ommen, 2020, 2020 AHA/ACC guideline for the diagnosis and treatment of patients with hypertrophic cardiomyopathy: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines, J Am Coll Cardiol source

      Checked before — its earlier verdict is held back until a new check runs.

24 of 24

  • The paper relies on this without support.

    ICD-10 codes accurately identify HCM and OSA in the TriNetX database.

    “Adults (≥18 years) with HCM (International Classification of Diseases [ICD]-10 I42.1/I42.2) and OSA (ICD-10 G47.33) were identified.”

  • The paper relies on this without support.

    Propensity score matching on measured covariates sufficiently controls confounding to allow the observed associations to be interpreted as approximate effects of GLP-1 RA exposure.

    “Propensity score matching (1:1) was performed across clinically relevant covariates (including demographics, specific cardiovascular and metabolic comorbidities, medication use, and laboratory variables) as shown in Figure 1A.”

  • The paper relies on this without support.

    GLP-1 RA exposure as recorded in the database reflects actual use.

    “Exposure group was GLP-1 RA use (on or after December 24, 2014) after the initial HCM diagnosis”

  • The paper relies on this without support.

    HCM-related decompensations are frequently driven by diastolic dysfunction, left ventricular outflow tract obstruction, and atrial arrhythmias.

    “HCM-related decompensations are frequently driven by diastolic dysfunction, left ventricular outflow tract obstruction, and atrial arrhythmias.”

  • The paper relies on this without support.

    Biomarker elevation may occur in the absence of obstructive coronary disease in HCM, making MI interpretation cautious.

    “interpretation of MI in HCM should remain cautious, as biomarker elevation may occur in the absence of obstructive coronary disease.”
5 of 5

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Prior HCM observational study is cited to the wrong reference

    Minor

    The cited reference 5 concerns tirzepatide for obstructive sleep apnea and obesity, not an observational study of GLP-1 RA use in HCM and obesity. The paper later identifies that prior HCM study as Fath et al, reference 6.

1 of 1

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Metadata

Authors
Shah, S., Abusafia, M., Sheashaa, H., Jadam, S., Ospina, S., Kaelber, D., Keen, S. K., & Desai, M. Y.
Affiliations
  • Cleveland Clinic (US)
  • MetroHealth (US)
Corresponding author
Desai, Milind Y.
ORCID
Venue
JACC: Advances
Publisher
Elsevier BV
Published
2026-10
Volume
5
Issue
10
Pages
102955
ISSN
2772-963X (ISSN-L)
DOI
10.1016/j.jacadv.2026.102955
PMC
PMC13699703
OpenAlex
W7204572594
Semantic Scholar
2953265fdf17104fedbde0e7b41d68a4916709d1
Cited by
0
References
6
FWCI
0.00
Type
journal article
Language
en
Open access
Licence
Locations
  • JACC Advances (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
GLP-1 receptor agonists, hypertrophic cardiomyopathy, obstructive sleep apnea, long-term outcomes, drug safety

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