Nat Rev Cardiol commentary: the REVEAL coronary benefit from CETP inhibition is probably down to lowering non-HDL-C, not raising HDL-C (Nat Rev Cardiol 2017)

A brief commentary notes that initial randomised trials of CETP inhibitors were terminated early for adverse effects or futility, before the REVEAL trial demonstrated a coronary heart disease benefit from CETP inhibition with anacetrapib. Despite CETP inhibitors raising HDL cholesterol levels, the authors argue the cardiovascular effect observed is probably attributable to the accompanying lowering of non-HDL cholesterol rather than to the HDL-cholesterol rise itself, reinforcing the reframing of CETP inhibition around apoB-containing lipoproteins rather than the original HDL-raising rationale.