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Cholesteryl ester transfer protein in patients with coronary heart disease

Kristina Duwensee1, Lutz Philipp Breitling, Ivan Tancevski

  • 1Department of Internal Medicine I, Innsbruck Medical University, Innsbruck, Austria.

European Journal of Clinical Investigation
|May 26, 2010
PubMed

Insights

Low cholesteryl ester transfer protein (CETP) levels may increase mortality risk in non-diabetic patients with coronary artery disease (CAD). This finding challenges the rationale for pharmacological CETP inhibition in atherosclerosis treatment.

Area of Science:

  • Cardiovascular Medicine
  • Lipid Metabolism
  • Atherosclerosis Research

Background:

  • The role of cholesteryl ester transfer protein (CETP) in atherosclerosis development remains debated.
  • This study investigates CETP associations with cardiovascular outcomes in stable coronary artery disease (CAD) patients.

Purpose of the Study:

  • To analyze the association between CETP levels and cardiovascular endpoints in a cohort of patients with stable CAD.
  • To evaluate the impact of CETP on mortality and secondary cardiovascular events.

Main Methods:

  • Prospective observational study (KAROLA) with 1132 CAD patients and 8-year median follow-up.
  • CETP levels measured via enzyme-linked immunosorbent assay.
  • Analysis of associations between CETP quartiles and clinical endpoints.

Main Results:

  • CETP levels were lower in men and correlated positively with LDL cholesterol and inversely with triglycerides.
  • No significant difference in overall mortality or secondary events across CETP quartiles.
  • Post hoc analysis revealed an adjusted hazard ratio of 1.84 for death in non-diabetic patients with low CETP levels.

Conclusions:

  • Emerging evidence, including this study's findings, challenges the concept of pharmacological CETP inhibition.
  • Effect sizes align with previous studies, suggesting CETP's complex role in cardiovascular disease.
  • Further research may be needed to clarify CETP's role, especially in specific patient subgroups.
Abstract

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