Cholesteryl ester transfer protein inhibitors: new concept of cardiovascular event prevention?

Abstract

Cholesteryl ester transfer protein (CETP) ensures transfers of cholesteryl esters and triglycerides between circulating high-density (HDL) and low-density (LDL) lipoproteins. Previous clinical studies have shown that CETP inhibitors had positive impact on the lipid profile, biomarkers of inflammation and oxidative stress, fasting glucose, but it was associated with several adverse effects, such as increase in blood pressure, electrolyte abnormalities, and serum levels of aldosterone. The HDL-target therapy had been discussed as promising among patients at higher risk of cardiovascular (CV) events and disease, because CETP inhibitor monotherapy and in combination with statins had exhibited a superiority in lipid profile improvement when compared with placebo or stains. However, the results of the clinical studies reading CV benefits of CETP inhibitors (torcetrapib, dalcetrapib, anacetrapib, evacetrapib) appeared to be controversial. The aim of the editorial is to summarize the clinical benefits of the CETP inhibitors in patients with CV disease and events prevention. The role of the CETP gene polymorphisms and other genetic variants are discussed to explain the results of previous clinical trials dedicated HDL-target therapy with the CETP inhibitors.