Maintained intentional weight loss reduces cardiovascular outcomes: results from the Sibutramine Cardiovascular OUTcomes (SCOUT) trial
Version of Record online: 18 JAN 2012
© 2011 Blackwell Publishing Ltd
Diabetes, Obesity and Metabolism
Volume 14, Issue 6, pages 523–530, June 2012
How to Cite
Caterson, I. D., Finer, N., Coutinho, W., Van Gaal, L. F., Maggioni, A. P., Torp-Pedersen, C., Sharma, A. M., Legler, U. F., Shepherd, G. M., Rode, R. A., Perdok, R. J., Renz, C. L., James, W. P. T. and on behalf of the SCOUT Investigators (2012), Maintained intentional weight loss reduces cardiovascular outcomes: results from the Sibutramine Cardiovascular OUTcomes (SCOUT) trial. Diabetes, Obesity and Metabolism, 14: 523–530. doi: 10.1111/j.1463-1326.2011.01554.x
- Issue online: 22 APR 2012
- Version of Record online: 18 JAN 2012
- Accepted manuscript online: 22 DEC 2011 02:16PM EST
- Date submitted 3 August 2011; date of first decision 17 September 2011; date of final acceptance 15 December 2011
- cardiovascular outcomes;
- weight loss
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.