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01-12-2009 | Cardiometabolic | Article

CETP inhibition may not lower CVD risk

Abstract

Free abstract

MedWire News: Low plasma cholesteryl ester transfer protein (CETP) activity is associated with increased cardiovascular disease (CVD) risk, show study results.

If confirmed, researchers say the results “challenge the concept that CETP inhibition may lower CVD risk.”

Inhibition of CETP raises high-density lipoprotein (HDL) cholesterol levels. Ramachandran Vasan (Framingham Heart Study, Boston University, Massachusetts, USA) and team measured CETP activity in 1978 participants of the Framingham Heart Study, aged 51 years on average, who attended a routine examination during 1987–1990. All participants were free of CVD at this point.

The participants were followed-up for an average period of 15.1 years, during which time 320 people experienced a CVD-related event (fatal or nonfatal coronary heart disease, peripheral vascular disease, cerebrovascular disease, or heart failure).

When the researchers adjusted for various standard confounders including HDL cholesterol they found that plasma CETP activity was inversely related to the incidence of CVD events.

CETP activity at, or above, 0.72 significantly reduced the risk for CVD events by 28% compared with lower levels. Each standard deviation increment of CETP activity significantly decreased the risk for CVD events by 14%.

“Inhibiting CETP activity raises HDL cholesterol and may be cardioprotective, but an initial clinical trial with a CETP inhibitor was stopped prematurely because of increased CVD in treated patients, raising concerns about this approach,” say Vasan et al.

The team concludes in the journal Circulation: “Our principal finding was an inverse relation of plasma CETP activity and CVD incidence.

“Although our findings are observational, the possibility that the observed relationship is a causal one is strengthened by its biological plausibility…, the demonstration of a linear dose response…, the presence of a temporal relationship…, and the consistency of the association in multiple analyses.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Helen Albert