Document Detail


Safety and impact on cardiovascular events of long-term multifactorial treatment in patients with metabolic syndrome and abnormal liver function tests: a post hoc analysis of the randomised ATTEMPT study.
MedLine Citation:
PMID:  22291824     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of metabolic syndrome (MetS), is common and accounts for 80% of cases of elevated liver function tests (LFTs). We assessed the long-term effects of multifactorial intervention on LFTs and their association with cardiovascular disease (CVD) events in patients with MetS without diabetes mellitus or CVD.
MATERIAL AND METHODS: This prospective, randomized, open label study included 1,123 patients (aged 45-65 years). Patients received intensive lifestyle intervention and pharmacotherapy: atorvastatin in all patients (low density lipoprotein cholesterol [LDL-C] targets of<100 mg/dl [group A] or<130 mg/dl [group B]), inhibitors of the renin-angiotensin-aldosterone axis for hypertension, metformin for dysglycaemia and orlistat for obesity.
RESULTS: Among participants, 326 had modestly elevated LFTs and ultrasonographic (US) evidence of NAFLD (165 patients in group A2 and 161 patients in group B2). The NAFLD resolved during the 42-month treatment period in 86% of patients in group A2 and in 74% of patients in group B2 (p<0.001). In both groups nearly 90% of patients attained lipid goals. Mean LDL-C and TG levels were higher in group B2 than in group A2 (p<0.001). There were no CVD events in group A2 whereas 5 non-fatal events occurred in group B2 (log-rank-p = 0.024). There were no major side-effects.
CONCLUSIONS: Attaining multiple treatment targets is safe and beneficial in primary prevention patients with MetS and NAFLD. Lipid levels and LFTs normalized, US findings associated with NAFLD resolved and no CVD events occurred in patients with LDL-C levels<100 mg/dl (group A2). Resolution of NAFLD might have contributed to the prevention of CVD events.
Authors:
Vassilios G Athyros; Olga Giouleme; Emmanouel S Ganotakis; Moses Elisaf; Konstantinos Tziomalos; Themistoklis Vassiliadis; Evangelos N Liberopoulos; Eleni Theocharidou; Asterios Karagiannis; Dimitri P Mikhailidis
Related Documents :
8416644 - Metastases to the pancreas and peripancreatic lymph nodes from carcinoma of the right s...
1532674 - Retroperitoneal laparostomy: a surgical treatment of pancreatic abscesses after an acut...
16698594 - Is there a role for serum endothelin in predicting the severity of acute pancreatitis?
6197334 - Comparative study of serum pancreatic isoamylase, lipase, and trypsin-like immunoreacti...
2129964 - Revised eeg coma scale in diffuse acute head injuries in adults.
20844474 - Serum levels of matrix metalloproteinase-10 are associated with the severity of atheros...
Publication Detail:
Type:  Journal Article     Date:  2011-11-08
Journal Detail:
Title:  Archives of medical science : AMS     Volume:  7     ISSN:  1896-9151     ISO Abbreviation:  Arch Med Sci     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2012-01-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101258257     Medline TA:  Arch Med Sci     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  796-805     Citation Subset:  -    
Affiliation:
2 Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  N-3 Polyunsaturated fatty acid therapy improves endothelial function and affects adiponectin and res...
Next Document:  The effect of diabetic autonomic neuropathy on P-wave duration, dispersion and atrial fibrillation.