Maintained intentional weight loss reduces cardiovascular outcomes: results from the Sibutramine Cardiovascular OUTcomes (SCOUT) trial.

Abstract

AIM:

The Sibutramine Cardiovascular OUTcomes trial showed that sibutramine produced greater mean weight loss than placebo but increased cardiovascular morbidity but not mortality. The relationship between 12-month weight loss and subsequent cardiovascular outcomes is explored.

METHODS:

Overweight/obese subjects (N = 10 744), ≥55 years with cardiovascular disease and/or type 2 diabetes mellitus, received sibutramine plus weight management during a 6-week Lead-in Period before randomization to continue sibutramine (N = 4906) or to receive placebo (N = 4898). The primary endpoint was the time from randomization to first occurrence of a primary outcome event (non-fatal myocardial infarction, non-fatal stroke, resuscitated cardiac arrest or cardiovascular death).

RESULTS:

For the total population, mean weight change during Lead-in Period (sibutramine) was -2.54 kg. Post-randomization, mean total weight change to Month 12 was -4.18 kg (sibutramine) or -1.87 kg (placebo). Degree of weight loss during Lead-in Period or through Month 12 was associated with a progressive reduction in risk for the total population in primary outcome events and cardiovascular mortality over the 5-year assessment. Although more events occurred in the randomized sibutramine group, on an average, a modest weight loss of approximately 3 kg achieved in the Lead-in Period appeared to offset this increased event rate. Moderate weight loss (3-10 kg) reduced cardiovascular deaths in those with severe, moderate or mild cardiovascular disease.

CONCLUSIONS:

Modest weight loss over short-term (6 weeks) and longer-term (6-12 months) periods is associated with reduction in subsequent cardiovascular mortality for the following 4-5 years even in those with pre-existing cardiovascular disease. While the sibutramine group experienced more primary outcome events than the placebo group, greater weight loss reduced overall risk of these occurring in both groups.

• Authors: I D Caterson, N Finer, W Coutinho, L F Van Gaal, A P Maggioni, C Torp-Pedersen, A M Sharma, U F Legler, G M Shepherd, R A Rode, R J Perdok, C L Renz, W P T James, SCOUT Investigators
• Journal: Diabetes, obesity & metabolism (Diabetes Obes Metab) Vol. 14 Issue 6 Pg. 523-30 (Jun 2012) ISSN: 1463-1326 [Electronic] England
• PMID: 22192338 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: © 2011 Blackwell Publishing Ltd.

Chemical References

• Appetite Depressants
• Cyclobutanes
• sibutramine

Topics

• Appetite Depressants (administration & dosage, pharmacology)
• Cardiovascular Diseases (etiology, mortality, prevention & control)
• Cyclobutanes (administration & dosage, pharmacology)
• Diabetes Mellitus, Type 2 (drug therapy, etiology, mortality)
• Double-Blind Method
• Female
• Humans
• Male
• Middle Aged
• Myocardial Infarction (prevention & control)
• Obesity (complications, drug therapy, mortality)
• Risk Factors
• Stroke (prevention & control)
• Treatment Outcome
• Weight Loss (drug effects)