CETP -629C/A genotype predicts HDL-C but the CC genotype benefits most from atorvastatin's LDL-C-lowering effect in Chinese CHD patients (Med Sci Monit 2014)

Original title: Effect of CETP polymorphism on atorvastatin lipid-regulating effect and clinical prognosis of patients with coronary heart disease

Med Sci Monit · 30 December 2014 · 7

Gu GL, Xu XL, Yang QY, Zeng RL

In 348 Han Chinese patients with angiographically confirmed coronary heart disease, the CETP -629C/A promoter polymorphism (A allele frequency 0.412) was genotyped, with lipids measured before and after 12 months of atorvastatin 20 mg/day. AA genotype carriers had lower CETP levels (P=0.026) and higher HDL-C (P=0.035) than CC or CA carriers at baseline. After 12 months of atorvastatin, CC genotype carriers showed greater reduction in LDL-C (P less than 0.001) and Lp(a) (P=0.005) and greater HDL-C elevation (P=0.045) than CA or AA carriers. Cumulative MACE-free survival differed numerically across genotypes (90.1%, 85.2%, and 71.1% for CC, CA, and AA respectively) after a mean 17.3-month follow-up, though the authors report long-term clinical prognosis was not significantly affected by genotype.

Original abstract

Background: The aim of this study was to investigate the influence of genetic polymorphism of cholesteryl ester transfer protein (CETP) gene polymorphism -629C/A on the therapeutic effect of atorvastatin and clinical outcome in Han Chinese patients with coronary heart disease (CHD).

Material And Methods: From October 2011 to December 2012, 348 patients with angiographically confirmed CHD were recruited. CETP gene polymorphism was determined by polymerase chain reaction-restricted fragment length polymorphism (PCR-RFLP) method. Serum level of CETP was determined with enzyme-1inked immunosorbent assay (ELISA). Lipid 1evel in all patients was determined at baseline and after 12 months of treatment with 20 mg/d of atorvastatin. All the patients were followed-up at least 12 months. Major adverse cardiac events, including death, non-fatal infarction, revascularization, and stroke (MACE), were recorded.

Results: The frequency of the -629A allele was 0.412. Compared with CC or CA genotypes, individuals with AA genotype had lower CETP levels (P=0.026) and higher high-density lipoprotein cholesterol (HDL-C) levels (P=0.035). After 12 months of atorvastatin therapy, carriers with CC genotype had greater reduction of low-density lipoprotein cholesterol (LDL-C) (P<0.001), reduced LP (a) (P=0.005), and elevated HDL-C (P=0.045) compared with CA or AA genotypes. The incidence of MACE after a mean follow-up of 17.3±5.2 months was 8.8%. The cumulative MACE-free survival rates were 90.1%, 85.2%, and 71.1% for CC, CA, and AA genotypes, respectively.

Conclusions: Our results suggest that the AA variant of the -629A allele of CETP gene had higher HDL-C levels and reduced CETP levels, but patients with CC genotype appeared to have benefited more from statin therapy with reduction in LDL-C and LP (a) levels. Long-term clinical prognosis was, however, not affected by the 3 genotypes.

Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.