A perspective argues the torcetrapib failure should redirect HDL drug development away from raw cholesterol concentration and toward specific antiatherosclerotic components (Ann Clin Biochem 2009)

This perspective examines the search for new coronary heart disease treatments centered on raising HDL cholesterol, arguing that the failure of the CETP inhibitor torcetrapib may force a rethink of this approach. The authors briefly review the antiatherosclerotic properties of HDL and the various ways HDL cholesterol concentration can be pharmacologically raised, but argue that because HDL cholesterol concentration does not reflect the protective properties of HDL particles, targeting the concentration alone is a flawed strategy. Instead, the authors call for a different approach that targets the known antiatherosclerotic components of HDL directly, rather than simply raising total HDL cholesterol as torcetrapib and similar agents do.