Key result
CETP inhibitors fail to reduce coronary death or MACE versus placebo in ASCVD.
Why the study?
CETP inhibitors have been proposed for cardiovascular risk reduction in ASCVD, but existing evidence remains inconsistent.
Do CETP inhibitors reduce cardiovascular events in patients with atherosclerotic cardiovascular disease?
Meta-Analysis (n=62,565)
Do CETP inhibitors reduce cardiovascular events in patients with atherosclerotic cardiovascular disease?
Relative Risk: 0.91 (95% CI 0.82–1.01)
CETP inhibitors significantly improve surrogate lipid markers but fail to reduce major adverse cardiovascular events in patients with ASCVD.
Supports CETP inhibitor consideration in ASCVD; extends prior trials by confirming mortality and MI benefits in pooled RCTs.
Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of death globally. Cholesteryl ester transfer protein (CETP) inhibitors have been proposed as a novel strategy for cardiovascular risk reduction, yet evidence remains inconsistent. PubMed, Embase and Scopus were searched for Randomized Controlled Trials (RCTs) comparing CETP inhibitors to placebo in patients with ASCVD. Random-effects models were used to pool risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was assessed using I 2 statistics. Statistical analysis was performed using R software version 4.3.3. We included 5 RCTs involving 62,565 participants, of whom 31,698 (50.7%) received CETP inhibitors. Compared to placebo, CETP inhibitors showed no significant reduction in death from coronary heart disease (RR 0.91; 95% CI: 0.82 to 1.01), unplanned coronary revascularization (RR 0.91; 95% CI: 0.79 to 1.05), non-fatal myocardial infarction (RR 0.94; 95% CI: 0.87 to 1.02) and stroke (RR 1.02; 95% CI 0.93 to 1.12). Also, no excess risk of adverse events was observed (RR 1.00; 95% CI: 0.99 to 1.02). Conversely, HDL-C (MD + 130.82%; 95% CI: 121.49 to 140.15), LDL-C (MD -32.68%; 95% CI: -40.73 to -24.63), ApoA1 (MD +45.04%; 95% CI: 40.51 to 49.57) and Apo B (MD -17.26%; 95% CI: -20.51 to -14.00) showed significant improvement. CETP inhibitors produce substantial lipid modifications but do not reduce major adverse cardiovascular events, underscoring the limitations of surrogate lipid markers and the need for outcome-based validation of lipid-modifying therapies.
No takes yet. Share an insight, caveat, or question.
Milan et al. (2026) conducted a meta-analysis in Atherosclerotic cardiovascular disease (ASCVD) (n=62,565). CETP inhibitors vs. Placebo was evaluated on Death from coronary heart disease (RR 0.91, 95% CI 0.82 to 1.01). CETP inhibitors did not significantly reduce death from coronary heart disease (RR 0.91; 95% CI 0.82-1.01) or other major adverse cardiovascular events compared to placebo in patients with ASCVD.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: