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Even in statin-treated patients with low LDL cholesterol levels, low HDL cholesterol remains a risk factor for coronary events (Journal Watch Sep 26 2007). In theory, raising HDL levels ought to prevent cardiovascular events in such patients. That theory was tested in an industry-supported study of torcetrapib, a drug that raises HDL levels by inhibiting cholesteryl ester transfer protein.
The 15,000 study participants had documented cardiovascular disease (82%) or diabetes (18%), and all had LDL cholesterol levels below 100 mg/dL on atorvastatin. They were randomized to receive torcetrapib or placebo; both groups continued atorvastatin. In the torcetrapib group at 1 year, mean HDL cholesterol levels had increased by 72% (from 49 mg/dL at ba…