Assessing the treatment effect in metabolic syndrome without perceptible diabetes (ATTEMPT): a prospective-randomized study in middle aged men and women (Journal article)

Athyros, V. G./ Ganotakis, E./ Kolovou, G. D./ Nicolaou, V./ Achimastos, A./ Bilianou, E./ Alexandrides, T./ Karagiannis, A./ Paletas, K./ Liberopoulos, E. N./ Tziomalos, K./ Petridis, D./ Kakafika, A./ Elisaf, M. S./ Mikhailidis, D. P.

AIM: To assess the reduction in estimated cardiovascular disease (e-CVD) risk after multifactorial treatment for 6 months and follow this change during the next 3-years. PATIENTS-METHODS: This prospective, randomized, target driven study included 1,123 subjects (512/611 men/women, aged 45-65 years) with metabolic syndrome (MetS) without diabetes or CVD referred to specialist outpatient clinics. Patients were randomized to two treatment groups: group A with low density lipoprotein cholesterol (LDL-C) target of < 100 mg/dl and group B with a target of < 130 mg/dl. Atorvastatin was used in both groups on top of optimal multifactorial treatment, (quinapril, amlodipine, hydrochlorothiazide for hypertension, metformin for impaired fasting glucose, and orlistat for obesity). The e-CVD risk was calculated using the Framingham, the PROCAM and Reynold's equations. RESULTS: Reductions in e-CVD risk at 6 months were > 50%in all patients, but were superior in group A and in women. Reductions were even greater during the next 3-years and were mainly attributed to changes in lipid profile. Actual CVD events were 1 in group A and 13 in group B; p=0.0012. CONCLUSIONS: Attaining the treatment target of LDL-C < 100 mg/dl within multifactorial treatment of MetS by expert clinics, is achievable and beneficial even in patients without diabetes or known CVD. This induces a considerable e-CVD risk reduction in MetS patients. Actual CVD events were negligible, suggesting that e-CVD risk overestimates actual CVD risk in MetS, at least in patients achieving LDL-C < 100 mg/dl [ClinicalTrials.gov ID: NCT00416741].
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Aged,Cardiovascular Diseases/etiology/*prevention & control,Cholesterol, LDL/blood/*drug effects,Female,Follow-Up Studies,Heptanoic Acids/*therapeutic use,Humans,Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use,Male,Metabolic Syndrome X/complications/*drug therapy,Middle Aged,Prospective Studies,Pyrroles/*therapeutic use,Risk Factors,Sex Factors
URI: https://olympias.lib.uoi.gr/jspui/handle/123456789/23694
ISSN: 1875-6212
Link: http://www.ncbi.nlm.nih.gov/pubmed/21476961
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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