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 .
Safety of anacetrapib in patients with or at high risk for coronary heart disease.
BACKGROUND Anacetrapib is a cholesteryl ester transfer protein inhibitor that raises high-density lipoprotein ( HDL ) cholesterol and reduces low-density lipoprotein ( LDL ) cholesterol . METHODS We conducted a r and omized , double-blind , placebo-controlled trial to assess the efficacy and safety profile of anacetrapib in patients with coronary heart disease or at high risk for coronary heart disease . Eligible patients who were taking a statin and who had an LDL cholesterol level that was consistent with that recommended in guidelines were assigned to receive 100 mg of  anacetrapib or placebo daily for 18 months . The primary end points were the percent change from baseline in LDL cholesterol at 24 weeks ( HDL cholesterol level was a secondary end point ) and the safety and side-effect profile of anacetrapib through 76 weeks . Cardiovascular events and deaths were prospect ively adjudicated . RESULTS A total of 1623 patients underwent r and omization . By 24 weeks , the LDL cholesterol level had been reduced from 81 mg per deciliter ( 2.1 mmol per liter ) to 45 mg per deciliter ( 1.2 mmol per liter ) in the anacetrapib group , as compared with a reduction from 82 mg per deciliter ( 2.1 mmol per liter ) to 77 mg per deciliter ( 2.0 mmol per liter ) in the placebo group (P<0.001)--a 39.8 % reduction with anacetrapib beyond that seen with placebo . In addition , the HDL cholesterol level increased from 41 mg per deciliter ( 1.0 mmol per liter ) to 101 mg per deciliter ( 2.6 mmol per liter ) in the anacetrapib group , as compared with an increase from 40 mg per deciliter ( 1.0 mmol per liter ) to 46 mg per deciliter ( 1.2 mmol per liter ) in the placebo group (P<0.001)--a 138.1 % increase with anacetrapib beyond that seen with placebo . Through 76 weeks , no changes were noted in blood pressure or electrolyte or aldosterone levels with anacetrapib as compared with placebo . Prespecified adjudicated cardiovascular events occurred in 16 patients treated with anacetrapib ( 2.0 % ) and 21 patients receiving placebo ( 2.6 % ) ( P = 0.40 ) . The prespecified Bayesian analysis indicated that this event distribution provided a predictive probability ( confidence ) of 94 % that anacetrapib would not be associated with a 25 % increase in cardiovascular events , as seen with torcetrapib . CONCLUSIONS Treatment with anacetrapib had robust effects on LDL and HDL cholesterol , had an acceptable side-effect profile , and , within the limits of the power of this study , did not result in the adverse cardiovascular effects observed with torcetrapib . ( Funded by Merck Research Laboratories ; Clinical Trials.gov number , NCT00685776 . )
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 .