Abstract

Despite the clinical use of statins to reduce serum levels of LDL cholesterol and treat atherosclerotic cardiovascular disease, a high proportion of patients remain at significant residual cardiovascular risk. In this context, low HDL cholesterol levels are an additional risk factor and intervention studies suggest that a fraction of the cardiovascular protection achieved with pharmacotherapy is explained specifically by the increase in serum levels of HDL cholesterol. Pharmacological inhibitors of the cholesteryl ester transfer protein (CETP) can induce a significant elevation in HDL cholesterol and, potentially, lead to better control of residual cardiovascular risk beyond the benefit demonstrated by statins. While the use of torcetrapib had unexpected side effects, dalcetrapib and anacetrapib are new CETP inhibitors with a better safety profile and are currently under study to evaluate their effects on vascular lesions and clinical events in patients at high cardiovascular risk. If these studies show positive findings, we will witness a new biomedical advance as significant as was the clinical.

Highlights

  • Correspondencia a: Dr Attilio Rigotti Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica, Marcoleta 367, Santiago

  • Despite the clinical use of statins to reduce serum levels of LDL cholesterol and treat atherosclerotic cardiovascular disease, a high proportion of patients remain at significant residual cardiovascular risk

  • Low HDL cholesterol levels are an additional risk factor and intervention studies suggest that a fraction of the cardiovascular protection achieved with pharmacotherapy is explained by the increase in serum levels of HDL cholesterol

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Summary

Introduction

Correspondencia a: Dr Attilio Rigotti Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica, Marcoleta 367, Santiago. Dado el potencial beneficio clínico de la elevación de los niveles del colesterol HDL y las limitaciones de los fármacos disponibles para este efecto, parece atractivo el desarrollo de inhibidores farmacológicos de la proteína de transferencia de ésteres de colesterol (cholesteryl ester transfer proteína, CETP), la cual media la transferencia de colesterol esterificado desde las partículas de HDL hacia las otras clases de lipoproteínas del plasma[3,8].

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