Effect of Torcetrapib on Carotid Atherosclerosis in Familial Hypercholesterolemia

Since torcetrapib, an inhibitor of cholesteryl ester transfer protein, markedly increases levels of high-density lipoprotein cholesterol and lowers levels of low-density lipoprotein cholesterol, in principle it might have a beneficial effect on atherosclerosis. However, in this clinical trial, torcetrapib had no beneficial effect on carotid atherosclerosis, as assessed by ultrasonographic measurement of carotid intima–media thickness. The reasons for this finding are unclear, but the drug did increase blood pressure slightly. In this clinical trial, torcetrapib had no beneficial effect on carotid atherosclerosis, as assessed by ultrasonographic measurement of carotid intima–media thickness.Published Online March 26, 2007 (DOI:10.1056/NEJMoa071359) Guidelines for the prevention and management of cardiovascular disease focus on reducing levels of low-density lipoprotein (LDL) cholesterol by means of hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (collectively referred to as statins). 1 , 2 However, recent meta-analyses have shown that even with the most aggressive treatment, 3 , 4 these drugs reduce the risk of a major coronary event by only 30%. 5 This finding, combined with an estimation that mortality from cardiovascular causes will increase worldwide by 90% by the year 2020, as compared with that in 1990, 6 illustrates the need for new efficacious treatments. A review of four large, prospective epidemiologic studies . . .