Cholesteryl Ester Transfer Protein Inhibitors and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Taheri H, Filion KB, Windle SB, Reynier P, Eisenberg MJ
Cardiology · 40 citas
Etiquetas de revisión
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Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2020-01-01 · Cardiology · vol. 145 · número 4 · págs. 236–250
- Editorial
- Karger Publishers
- Citado
- 54 citas · más que el 91% de estudios similares · 2.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 33 trabajos
- Acceso
- De pago
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Cholesterol and Lipid Metabolism · Paraoxonase enzyme and polymorphisms
- Palabras clave
- cholesteryl ester transfer protein inhibitors, CETP inhibitors, dalcetrapib, anacetrapib, evacetrapib, HDL cholesterol, LDL cholesterol, major adverse cardiovascular events, cardiovascular mortality, myocardial infarction, lipid profile
- MeSH
- humans, cardiovascular diseases, anticholesteremic agents, cholesterol, ldl, cholesterol, hdl, cholesterol ester transfer proteins, randomized controlled trials as topic
5 autores
- Hossein Taheri🇨🇦Jewish General Hospital; Lady Davis Institute for Medical Research; McGill University
- Kristian B. Filion🇨🇦Jewish General Hospital; Lady Davis Institute for Medical Research; McGill University
- Sarah B. Windle🇨🇦Jewish General Hospital; Lady Davis Institute for Medical Research; McGill University
- Pauline Reynier🇨🇦Jewish General Hospital; Lady Davis Institute for Medical Research; McGill University
- Mark Jeffrey Eisenberg🇨🇦Jewish General Hospital; Lady Davis Institute for Medical Research; McGill University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Cholesteryl ester transfer protein (CETP) inhibitors increase serum high-density lipoprotein cholesterol (HDL-c) concentration; however, their impact on cardiovascular outcomes is not clear. This systematic review examines the effect of CETP inhibitors on serum lipid profiles, cardiovascular events, and all-cause mortality.
Methods
We searched MEDLINE, Embase, and the Cochrane Library of Clinical Trials for placebo-controlled randomized controlled trials (RCTs) that examined the effect of a CETP inhibitor (dalcetrapib, anacetrapib, evacetrapib, or TA-8995) on all-cause mortality, major adverse cardiovascular events (MACE), or the components of MACE at ≥6 months. Data were pooled using random-effects models.
Results
A total of 11 RCTs (n = 62,431) were included in our systematic review; 4 examined dalcetrapib (n = 16,612), 6 anacetrapib (n = 33,682), and 1 evacetrapib (n = 12,092). Compared to dalcetrapib, ana-cetrapib and evacetrapib were more efficacious at raising HDL-c levels (∼100-130 vs. ∼30%). Anacetrapib and evacetrapib also decreased low-density lipoprotein cholesterol (LDL-c) by approximately 30% while dalcetrapib did not affect the LDL-c level. Overall, CETP inhibitors were not associated with the incidence of MACE (pooled relative risk [RR]: 0.97; 95% confidence interval [CI]: 0.91-1.04). CETP inhibitors may decrease the risks of nonfatal myocardial infarction (MI) (RR: 0.93; 95% CI: 0.87-1.00) and cardiovascular death (RR: 0.92; 95% CI: 0.83-1.01), though these trends did not reach statistical significance.
Conclusions
CETP inhibitors are not associated with an increased risk of MACE or all-cause mortality. There is a trend towards small reductions in nonfatal MI and cardiovascular death, though the clinical im-portance of such reductions is likely modest.
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