The class
Low plasma CETP predicts higher mortality in nondiabetic coronary disease patients in the KAROLA cohort (Eur J Clin Invest 2010)
Original title: Cholesteryl ester transfer protein in patients with coronary heart disease
In the KAROLA cohort of 1,132 patients with stable coronary artery disease followed for a median of eight years, plasma CETP levels were lower in men, positively correlated with LDL cholesterol, and inversely correlated with triglycerides. Overall mortality did not differ significantly across CETP quartiles, but in post hoc analysis of nondiabetic subjects, low CETP levels carried an adjusted hazard ratio for death of 1.84 (95% CI 1.10 to 3.09) compared with high CETP levels. The authors note these effect sizes align with earlier Framingham and LURIC findings and argue the accumulating evidence challenges the rationale for pharmacological CETP inhibition.
Original abstract
Background: The impact of cholesteryl ester transfer protein (CETP) in the development of atherosclerosis is a matter for ongoing debate. In this study, we analyse associations of CETP with cardiovascular endpoints in a cohort of patients with stable coronary artery disease (CAD).
Design: KAROLA is a prospective observational study of patients with CAD and a median follow-up of 8 years (n = 1132). CETP levels were measured using an enzyme-linked immunosorbent assay.
Results: Cholesteryl ester transfer protein levels were lower in men (P = 0.0016), positively correlated to low-density lipoprotein cholesterol, and inversely correlated to triglyceride levels (P < 0.0001 and P = 0.011 respectively). There was no significant difference in mortality between patients in different CETP quartiles; the hazard ratio of lowest vs. highest quartile was 1.33 (95% confidence interval (CI): 0.77-2.30) for mortality and 1.24 (95% CI: 0.75-2.03) for secondary events. In post hoc analyses, comparing nondiabetic subjects with CETP below vs. above median, the adjusted hazard ratio for death in patients with low CETP levels was 1.84 (95% CI: 1.10-3.09).
Conclusion: Although statistically significant associations were found only in post hoc analyses, the effect sizes in this study were in line with previous findings in the Framingham and LURIC population. In combination, the emerging evidence challenges the concept of pharmacological CETP inhibition.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.