Orlistat may reduce risk of major adverse cardiovascular events, EHJ study

The rising prevalence of obesity and its associated comorbidities represent a growing public health issue; in particular, obesity is known to be a major risk factor for cardiovascular disease. Despite the evidence behind the efficacy of orlistat in achieving weight loss in patients with obesity, no study thus far has quantified its long-term effect on cardiovascular outcomes. The purpose of the current study was to explore long-term cardiovascular outcomes after orlistat therapy.

For the study design, researchers selected a propensity-score matched cohort study on the nation-wide electronic primary and integrated secondary healthcare records of the Clinical Practice Research Datalink (CPRD). The 36 876 patients with obesity in the CPRD database who had completed a course of orlistat during follow-up were matched on a 1:1 basis with equal numbers of controls who had not taken orlistat. Patients were followed up for a median of 6 years for the occurrence of the primary composite endpoint of major adverse cardiovascular events (fatal or non-fatal myocardial infarction or ischaemic stroke), and a number of secondary endpoints including primary endpoint components individually, the occurrence of new-onset heart failure, coronary revascularization, new chronic kidney disease stage III+ (CKD3+), and all-cause mortality.

Data analysis highlighted some key facts.

• During the median study follow-up of 6 years, the occurrence of major adverse cardiovascular events was lower in the orlistat cohort [hazard ratio (HR) 0.74; 95% confidence interval (CI) 0.66–0.83, P < 0.001].
• Patients who took orlistat experienced lower rates of myocardial infarction (HR 0.77; 95% CI 0.66–0.88, P < 0.001) and ischaemic stroke (HR 0.68; 95% CI 0.56 to −0.84, P < 0.001) as well as new-onset heart failure (HR 0.79; 95% CI 0.67–0.94, P = 0.007).
• There was no differences in revascularization rates (HR 1.12; 95% CI 0.91–1.38, P = 0.27), but a lower rate of both CKD3+ development (HR 0.78; 95% CI 0.73–0.83, P < 0.001) and mortality (HR 0.39, 95% CI 0.36 to −0.41, P < 0.001) was observed.

"This study adds to current evidence on the known improvements in cardiovascular risk factor profiles of orlistat treatment by suggesting a potential role in primary prevention."the research team concluded.

For full article follow the link: https://doi.org/10.1093/ehjcvp/pvaa133

Source: European Heart Journal