The trial, Effects of the Cholesteryl Ester Transfer Protein Inhibitor Dalcetrapib in Patients with Recent Acute Coronary Syndrome (dal OUTCOMES) is the second study in this class of drugs that has had relatively disappointing outcomes in terms of cholesteryl ester transfer protein (CETP) inhibitors increasing HDL, but not affecting CVD risk.
According to a press release by the American Heart Association, dalcetrapib increased levels of HDL cholesterol by about 30 percent. However, among nearly 16,000 patients followed for an average of about 2 ½ years, this HDL cholesterol boost didn’t reduce patients’ risk of death, another heart attack, hospitalization for heart-related chest pain, or stroke.
The Preventive Cardiovascular Nurses Association (PCNA) is recommending that practitioners watch these trials, yet keep focus on lowering LDL rather than raising HDL.
“It is important to continue to observe and wait for outcomes of ongoing trials in both this class of CETP inhibiting drugs and other drug classes,” says Mary Ann Champagne, MSN, CNS, FAHA, FPCNA, clinical nurse specialist at Stanford University Medical Center’s Preventive Cardiology Clinic and member of the PCNA board of directors. “We should not lose focus on lowering LDL as most important – as this is where the outcome data is. There needs to be further research on what factors are important about HDL and if HDL is a risk factor or risk marker for cardiovascular disease.”
The Effects of the Cholesteryl Ester Transfer Protein Inhibitor Dalcetrapib in Patients with Recent Acute Coronary Syndrome (dal OUTCOMES) is also published in the New England Journal of Medicine.
Preventive Cardiovascular Nurses Association