Conclusions : CETP inhibitors are not associated with an increased risk of MACE or all-cause mortality .
There is a trend towards small reductions in nonfatal MI and cardiovascular death , though the clinical importance of such reductions is likely modest
Background : Cholesteryl ester transfer protein ( CETP ) inhibitors increase serum high-density lipoprotein cholesterol ( HDL-c ) concentration ; however , their impact on cardiovascular outcomes is not clear .
This systematic review examines the effect of CETP inhibitors on serum lipid profiles , cardiovascular events , and all-cause mortality .
Evacetrapib and Cardiovascular Outcomes in High‐Risk Vascular Disease
BACKGROUND The cholesteryl ester transfer protein inhibitor evacetrapib substantially raises the high‐density lipoprotein ( HDL ) cholesterol level , reduces the low‐density lipoprotein ( LDL ) cholesterol level , and enhances cellular cholesterol efflux capacity . We sought to determine the effect of evacetrapib on major adverse cardiovascular outcomes in patients with high‐risk vascular disease . METHODS In a multicenter , r and omized , double‐blind , placebo‐controlled phase 3 trial , we enrolled 12,092 patients who had at least one of the following conditions : an acute coronary syndrome within the previous 30 to 365 days , cerebrovascular atherosclerotic disease , peripheral vascular arterial disease , or diabetes mellitus with coronary artery disease . Patients were r and omly assigned to receive either evacetrapib at a dose of 130 mg or matching placebo , administered daily , in addition to st and ard medical therapy . The primary efficacy end point was the first occurrence of any component of the composite of death from cardiovascular causes , myocardial infa rct ion , stroke , coronary revascularization , or hospitalization for unstable angina . RESULTS At 3 months , a 31.1 % decrease in the mean LDL cholesterol level was observed with evacetrapib versus a 6.0 % increase with placebo , and a 133.2 % increase in the mean HDL cholesterol level was seen with evacetrapib versus a 1.6 % increase with placebo . After 1363 of the planned 1670 primary end‐point events had occurred , the data and safety monitoring board recommended that the trial be terminated early because of a lack of efficacy . After a median of 26 months of evacetrapib or placebo , a primary end‐point event occurred in 12.9 % of the patients in the evacetrapib group and in 12.8 % of those in the placebo group ( hazard ratio , 1.01 ; 95 % confidence interval , 0.91 to 1.11 ; P=0.91 ) . CONCLUSIONS Although the cholesteryl ester transfer protein inhibitor evacetrapib had favorable effects on established lipid biomarkers , treatment with evacetrapib did not result in a lower rate of cardiovascular events  than placebo among patients with high‐risk vascular disease . ( Funded by Eli Lilly ; ACCELERATE Clinical Trials.gov number , NCT01687998 .
Conclusions : CETP inhibitors are not associated with an increased risk of MACE or all-cause mortality .
There is a trend towards small reductions in nonfatal MI and cardiovascular death , though the clinical importance of such reductions is likely modest
Background : Cholesteryl ester transfer protein ( CETP ) inhibitors increase serum high-density lipoprotein cholesterol ( HDL-c ) concentration ; however , their impact on cardiovascular outcomes is not clear .
This systematic review examines the effect of CETP inhibitors on serum lipid profiles , cardiovascular events , and all-cause mortality .