Some drugs that lower bad cholesterol numbers on a blood test don't actually prevent heart attacks because they don't reduce the number of harmful cholesterol particles, or they raise blood pressure,...
Claim Context
Cholesteryl ester transfer protein (CETP) inhibitors reduce LDL cholesterol but do not reduce cardiovascular event risk, likely due to discordance between LDL-C lowering and actual reduction in LDL particle number (apoB) or due to off-target adverse effects such as increased blood pressure, indicating that not all LDL-C lowering is beneficial unless it reflects true reduction in atherogenic particle burden.
“In the recently reported ACCELERATE Trial, the CETP inhibitor evacetrapib plus a statin reduced LDL-C by 0.75 mmol/L compared with statin monotherapy but did not reduce the risk of cardiovascular events... the LDL particle-lowering effect of CETP inhibitors appears to become attenuated when a CETP...”
Evidence from Studies
No evidence studies found yet.
What Would Prove This
Per GRADE and EBM methodology, here is what ideal scientific evidence would look like to definitively prove or disprove this claim, ordered from strongest to weakest.
Definitively test whether CETP inhibition reduces ASCVD risk.
A double-blind RCT of 30,000 high-risk patients randomized to anacetrapib vs placebo on top of statin therapy, followed for 5 years for major ASCVD events, with serial measurements of LDL-C, apoB, and blood pressure.
Assess real-world outcomes in patients prescribed CETP inhibitors.
A prospective cohort of 50,000 patients on CETP inhibitors, tracking ASCVD events, apoB, and LDL-C over 5 years, compared to matched controls on other LDL-lowering therapies.