TY - JOUR T1 - CETP inhibition improves the lipid profile but has no effect on clinical cardiovascular outcomes in high-risk patients JF - Evidence Based Medicine JO - Evid Based Med SP - 184 LP - 185 DO - 10.1136/ebmed-2017-110791 VL - 22 IS - 5 AU - Robert S Rosenson Y1 - 2017/10/01 UR - http://ebm.bmj.com/content/22/5/184.abstract N2 - Commentary on: Lincoff AM, Nicholls SJ, Riesmeyer JS, et al. Evacetrapib and cardiovascular outcomes in high-risk vascular disease. N Engl J Med 2017;376:1933–42.High-density lipoprotein (HDL) cholesterol (HDL-C) is a robust predictor of cardiovascular disease (CVD) events; however, research into both rare monogenic HDL disorders and Mendelian randomisation studies of dysfunctional traits associated with HDL-C demonstrate that this biomarker is not involved in the causal pathway for atherosclerosis.1 Small-effect variants in the gene encoding cholesteryl ester transfer protein (CETP) associate with higher HDL-C and lower myocardial infarction rates, whereas large-effect variants associate with reduced survival. CETP loss-of-function variants also associate with low levels of low-density lipoprotein (LDL) cholesterol (LDL-C), which confounds the attribution of the atheroprotective effect of CETP-mediated HDL changes.Small molecules that inhibit CETP activity have been previously investigated in two randomised clinical trials of CVD outcomes.2 3 Treatment with torcetrapib, in combination with atorvastatin increased HDL-C … ER -