Cholesteryl Ester Transfer Protein and Mortality in Patients Undergoing Coronary Angiography: The Ludwigshafen Risk and Cardiovascular Health Study
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Background— The role of cholesteryl ester transfer protein (CETP) in the development of atherosclerosis is still open to debate. In the Investigation of Lipid Level Management to Understand its Impact in Atherosclerotic Events (ILLUMINATE) trial, inhibition of CETP in patients with high cardiovascular risk was associated with increased high-density lipoprotein levels but increased risk of cardiovascular morbidity and mortality. In this report, we present a prospective observational study of patients referred to coronary angiography in which CETP was examined in relation to morbidity and mortality. Methods and Results— CETP concentration was determined in 3256 participants of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study who were referred to coronary angiography at baseline between 1997 and 2000. Median follow-up time was 7.75 years. Primary and secondary end points were cardiovascular and all-cause mortality, respectively. CETP levels were higher in women and lower in smokers, in diabetic patients, and in patients with unstable coronary artery disease, respectively. In addition, CETP levels were correlated negatively with high-sensitivity C-reactive protein and interleukin-6. After adjustment for age, sex, medication, coronary artery disease status, cardiovascular risk factors, and diabetes mellitus, the hazard ratio for death in the lowest CETP quartile was 1.33 (1.07 to 1.65; P =0.011) compared with patients in the highest CETP quartile. Corresponding hazard ratios for death in the second and third CETP quartiles were 1.17 (0.92 to 1.48; P =0.19) and 1.10 (0.86 to 1.39; P =0.46), respectively. Conclusions— We interpret our data to suggest that low endogenous CETP plasma levels per se are associated with increased cardiovascular and all-cause mortality, challenging the rationale of pharmacological CETP inhibition.
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A slightly increased cardiovascular mortality was observed at low concentrations of CETP in the blood despite high HDL-C.
“We observed a slightly increased cardiovascular mortality at low concentrations of CETP in the blood despite high HDL-C [37].”
From HDL cholesterol: reappraisal of its clinical relevance (2017) · cites this paper as [37]
Many studies in which CETP was tested in the plasma showed an inverse correlation between CETP and cardiovascular risk.
“On the other hand, many studies in which CETP was tested in the plasma showed an inverse correlation between CETP and cardiovascular risk [37, 103].”
From HDL cholesterol: reappraisal of its clinical relevance (2017) · cites this paper as [37]
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- Authors
- Ritsch, A., Scharnagl, H., Eller, P., Tancevski, I., Duwensee, K., Demetz, E., Sandhofer, A., Boehm, B. O., Winkelmann, B. R., Patsch, J. R., & März, W.
- Affiliations
- Innsbruck Medical University (AT)
- From the Department of Internal Medicine I, Innsbruck Medical University, Innsbruck, Austria (A.R., P.E., I.T., K.D., E.D., A.S., J.R.P.); Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria (H.S., W.M.); Division of Endocrinology, Department of Medicine, University Hospital, Ulm, Germany (B.O.B.); Cardiology Group, Frankfurt-Sachsenhausen, Germany (B.R.W.); Synlab Center of Laboratory Diagnostics, Heidelberg, Germany (W.M.); and Mannheim...
- Venue
- Circulation
- Published
- 2010-01-26
- Volume
- 121
- Issue
- 3
- Pages
- 366-374
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC2964596
- OpenAlex
- W1976347559
- Cited by
- 104
- References
- 23
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 1 · 2022: 4 · 2021: 1 · 2020: 1 · 2019: 5 · 2018: 3 · 2017: 6 · 2016: 12 · 2015: 10 · 2014: 12 · 2013: 12 · 2012: 9
- FWCI
- 14.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Paraoxonase enzyme and polymorphisms
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Keywords
- cholesteryl ester transfer protein, cardiovascular mortality, all-cause mortality, coronary angiography, coronary artery disease, atherosclerosis, high-density lipoprotein, C-reactive protein, interleukin-6, CETP inhibition, ILLUMINATE trial, LURIC study, cardiovascular risk factors
- MeSH terms
- Aged, C-Reactive Protein, Coronary Artery Disease, Female, Follow-Up Studies, Humans, Lipoproteins, Male, Middle Aged, Morbidity, Referral and Consultation, Risk Factors, Biomarkers, Interleukin-6, Proportional Hazards Models, Coronary Angiography, Cholesterol Ester Transfer Proteins
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