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Byatis, the serpent-bearded, the god of forgetfulness, came with the Great Old Ones from the stars, called by obeisances made to his image, which was brought by the Deep Ones to Earth.
Nick Mamatas's 2004 novel Move Under Ground, set in a world where Cthulhu has taken power and only the Beats oppose him, the power of the Great Old Ones twists the constellations into new shapes, using them as vessels for his surrogates; among them, Jack Kerouac observes the "red stars of Azathoth".
Aside from these conflicts, the game focuses on other factions, such as ancient cults like the Esoteric Order of Dagon that are running amok across the planet and the eldritch horrors that are rising to destroy the world as, according to the prophecies of the Cthulhu Mythos, the "stars are right" and the Great Old Ones and their servitors are returning/reawakening to reclaim the Earth.
Cthulhu is a fictional giant creature, one of the Great Old Ones in H. P. Lovecraft's Cthulhu Mythos.