High levels of HDL are known to exert a protective effect. In previous studies, dalcetrapib administration increased HDL 30% from baseline. The objective was to test dalcetrapib in the context of acute coronary syndrome (ACS). 15,871 ACS patients were randomized to receive dalcetrapib or placebo. Primary end point was cardiac death, myocardial infarction, ictus, new hospitalization for ACS or cardiopulmonary reanimation. 97% of patients received some kind of revascularization, the rest of the medical treatment was standard. Follow up at 31 months showed an increase of 30% in HDL levels, but there were no differences in the primary end point (HR = 1,04 p = 0,52). A significative increase in blood pressure and CF reactive protein was observed, compared to the placebo group.
Conclusion: Dalcetrapib did not reduce events in patients with ACS.
Comment: Yet once more the laboratory effects of a physiopathologically interesting drug did not translate into the expected clinical results. Other drugs in the same family showed the same side effects on blood pressure, which suggests a class effect. There is no evidence to support the use of dalcetrapib in the context of ACS
Gregory G Schwartz
2012-11-05
Original title: Effects of the Cholesteryl Ester Transfer Protein Inhibitor Dalcetrapib in Patients with Recent Acute Coronary Syndrome.
