title: Maintained intentional weight loss reduces cardiovascular outcomes: results from the Sibutramine Cardiovascular OUTcomes (SCOUT) trial.
abstract: OBJECTIVE
  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.affiliation: Boden Institute of Obesity Nutrition, Exercise & Eating Disorders, University of Sydney, NSW, Australia. ian.caterson@sydney.edu.au
authors.forename: I D
authors.initials: ID
authors.lastname: Caterson
authors.forename: N
authors.initials: N
authors.lastname: Finer
authors.forename: W
authors.initials: W
authors.lastname: Coutinho
authors.forename: L F
authors.initials: LF
authors.lastname: Van Gaal
authors.forename: A P
authors.initials: AP
authors.lastname: Maggioni
authors.forename: C
authors.initials: C
authors.lastname: Torp-Pedersen
authors.forename: A M
authors.initials: AM
authors.lastname: Sharma
authors.forename: U F
authors.initials: UF
authors.lastname: Legler
authors.forename: G M
authors.initials: GM
authors.lastname: Shepherd
authors.forename: R A
authors.initials: RA
authors.lastname: Rode
authors.forename: R J
authors.initials: RJ
authors.lastname: Perdok
authors.forename: C L
authors.initials: CL
authors.lastname: Renz
authors.forename: W P T
authors.initials: WP
authors.lastname: James
mesh_terms: D001067:Appetite Depressants / Q000008:administration & dosage* / Q000494:pharmacology; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D003503:Cyclobutanes / Q000008:administration & dosage* / Q000494:pharmacology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control; D009765:Obesity / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D001067:Appetite Depressants; D003503:Cyclobutanes; C058254:sibutramine