JOURNAL ARTICLE
REVIEW

Increasing high-density lipoprotein cholesterol, inhibition of cholesteryl ester transfer protein, and heart disease risk reduction

Ernst J Schaefer, Bela F Asztalos
American Journal of Cardiology 2007 December 3, 100 (11): n25-31
18047849
Our purpose is to review recent research in the area of high-density lipoprotein (HDL) cholesterol raising and coronary artery disease (CAD) risk reduction. It is known that a decreased HDL cholesterol level is an important CAD risk factor and that raising HDL cholesterol has been associated with CAD risk reduction. A relative new strategy for raising HDL cholesterol, inhibition of cholesteryl ester transfer protein (CETP), is markedly effective. CETP inhibitors prevent the transfer of cholesteryl ester from HDL to triglyceride-rich lipoproteins in exchange for triglyceride. One inhibitor, torcetrapib, binds to CETP on HDL, markedly increases HDL cholesteryl ester, has no effect on fecal cholesterol excretion, but can raise blood pressure. A large clinical trial in patients with CAD who were taking atorvastatin was recently stopped prematurely because of excess mortality in those receiving torcetrapib versus placebo, and 2 other trials reported no benefit of torcetrapib on coronary atherosclerosis or carotid intima-media thickness as compared with subjects on atorvastatin alone. The adverse effects of torcetrapib may be compound specific, and because the crystal structure of CETP is now known, it should be possible to develop more optimal CETP inhibitors that do not form a nonproductive complex with CETP on the HDL particle, as has been reported for torcetrapib. Another alternative for increasing HDL levels is to develop more effective and better tolerated niacin preparations.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
18047849
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"