Association between the changes in renal function and serum uric acid levels during multifactorial intervention and clinical outcome in patients with metabolic syndrome. A post hoc analysis of the ATTEMPT study

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dc.contributor.authorAthyros, V. G.en
dc.contributor.authorKaragiannis, A.en
dc.contributor.authorGanotakis, E. S.en
dc.contributor.authorPaletas, K.en
dc.contributor.authorNicolaou, V.en
dc.contributor.authorBacharoudis, G.en
dc.contributor.authorTziomalos, K.en
dc.contributor.authorAlexandrides, T.en
dc.contributor.authorLiberopoulos, E. N.en
dc.contributor.authorMikhailidis, D. P.en
dc.date.accessioned2015-11-24T19:35:01Z
dc.date.available2015-11-24T19:35:01Z
dc.identifier.issn1473-4877-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/23671
dc.rightsDefault Licence-
dc.subjectAgeden
dc.subjectCardiovascular Diseases/blood/drug therapy/etiology/mortality/physiopathologyen
dc.subjectCholesterol, LDL/*blooden
dc.subjectDisease-Free Survivalen
dc.subjectFemaleen
dc.subjectGlomerular Filtration Rate/*drug effectsen
dc.subjectHeptanoic Acids/*administration & dosageen
dc.subjectHumansen
dc.subjectHydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosageen
dc.subjectKidney/*physiopathologyen
dc.subjectMaleen
dc.subject*Metabolic Syndrome X/blood/complications/drug therapy/mortality/physiopathologyen
dc.subjectMiddle Ageden
dc.subjectProspective Studiesen
dc.subjectPyrroles/*administration & dosageen
dc.subjectUric Acid/*blooden
dc.titleAssociation between the changes in renal function and serum uric acid levels during multifactorial intervention and clinical outcome in patients with metabolic syndrome. A post hoc analysis of the ATTEMPT studyen
heal.abstractAIM: To assess the effects of long-term multifactorial intervention on renal function and serum uric acid (SUA) levels and their association with estimated cardiovascular disease (eCVD) risk and actual CVD events. METHODS: This prospective, randomized, target-driven study included 1123 subjects (45.6% men, age 45-65 years) with metabolic syndrome (MetS) but without diabetes or CVD. Patients were randomized to multifactorial treatment. Atorvastatin was titrated from 10-80 mg/day aiming at a low density lipoprotein cholesterol (LDL-C) target of <100 mg/dl (group A) or an LDL-C target of <130 mg/dl (group B). Changes in estimated glomerular filtration rate (eGFR) and SUA levels were recorded in all patients and in the subgroup with stage 3 chronic kidney disease (CKD; eGFR = 30-59 ml/min/1.73 m(2); n = 349). We used ANOVA to compare changes within the same group, unpaired Student t-test to compare results between groups at specific time points, and log-rank test to compare event free survival. RESULTS: The eCVD-risk reduction was greater in group A. In the overall study population, eGFR increased by 3.5% (p < 0.001) and SUA levels fell by 5.6% (p < 0.001). In patients from group A with stage 3 CKD (group A1; n = 172), eGFR increased by 11.1% (p < 0.001) from baseline and by 7.5% (p < 0.001) in group B1 (n = 177; p < 0.001 vs. the change in group A1). The corresponding fall in SUA levels was 10.7% in group A1 (p < 0.001 vs. baseline) and 8.3% in group B1 (p < 0.001 vs. baseline and group A1). These changes were mainly attributed to atorvastatin treatment. Among the CKD stage 3 patients there were no CVD events in group A1, while 6 events occurred in group B1 (p = 0.014). CONCLUSIONS: Multifactorial intervention in patients with MetS without established CVD improved renal function and reduced SUA levels. These changes were more prominent in stage 3 CKD patients and might have contributed to the reduction in eCVD risk and clinical events. Original study registration number [ClinicalTrials.gov ID: NCT00416741].en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1185/03007995.2011.595782-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/21714711-
heal.identifier.secondaryhttp://informahealthcare.com/doi/abs/10.1185/03007995.2011.595782-
heal.journalNameCurrent Medical Research and Opinionen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2011-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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