HDL biology
High baseline CETP predicts worse atherosclerosis progression on statins in familial hypercholesterolemia (Atherosclerosis 2004)
Original title: The relationship between cholesteryl ester transfer protein levels and risk factor profile in patients with familial hypercholesterolemia
In 281 patients with familial hypercholesterolemia followed in a 2-year randomized double-blind comparison of two statins, patients were stratified into quartiles by baseline CETP level. Higher CETP levels correlated with lower HDL-cholesterol, higher LDL-cholesterol and triglycerides, reduced HDL particle size, and smaller, denser LDL. Statin therapy reduced plasma CETP and atherogenic lipoproteins overall, but baseline CETP concentration remained positively associated with carotid intima-media thickness (IMT) progression after two years of treatment. CETP levels are thus linked to a more atherogenic lipid profile and to greater atherosclerosis progression, and statin therapy appears to leave lipoprotein abnormalities associated with high CETP levels incompletely corrected.
Original abstract
Background: Cholesteryl ester transfer protein (CETP) mediates the transfer of neutral lipids between lipoproteins. The role of CETP in atherogenesis is controversial. To better understand the relationships between plasma CETP levels, lipoproteins and atherosclerosis, we assessed these parameters in patients with an enhanced risk for atherosclerosis.
Methods And Results: We investigated 281 patients with familial hypercholesterolemia (FH) in which the effects of two statins were compared in a 2-year, randomized, double-blinded study. Patients were stratified in quartiles according to their CETP baseline levels. In addition to correlations with decreased high-density lipoprotein cholesterol (HDL-c), increased low-density lipoprotein cholesterol (LDL-c) and enhanced triglyceride levels, higher CETP levels were also associated with reduced HDL particle size, and smaller and denser LDL. Statins reduced plasma CETP levels and atherogenic lipoproteins. Nevertheless, baseline CETP concentration was positively associated with IMT after 2 years of therapy.
Conclusion: This study provides evidence that CETP levels are associated with a more atherogenic lipid profile and increased progression of atherosclerosis. Statin treatment improved the lipoprotein profile in FH patients, but to a lesser extent in those with high CETP levels. These findings might imply that statin treatment does not entirely counteract the lipoprotein abnormalities associated with high CETP levels.
familial hypercholesterolaemiaHDL biologyplaque imaging
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.