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首页> 外文期刊>Cardiology >Cholesteryl Ester Transfer Protein Inhibitors and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
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Cholesteryl Ester Transfer Protein Inhibitors and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

机译：胆固醇酯转移蛋白抑制剂和心血管结果：随机对照试验的系统评价和荟萃分析

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Background: Cholesteryl ester transfer protein (CETP) inhibitors increase serum high-density lipoprotein cholesterol (HDL-c) concentration; however, their impact on cardiovascular outcomes is not clear. This systematic review examines the effect of CETP inhibitors on serum lipid profiles, cardiovascular events, and all-cause mortality. Methods: We searched MEDLINE, Embase, and the Cochrane Library of Clinical Trials for placebo-controlled randomized controlled trials (RCTs) that examined the effect of a CETP inhibitor (dalcetrapib, anacetrapib, evacetrapib, or TA-8995) on all-cause mortality, major adverse cardiovascular events (MACE), or the components of MACE at >= 6 months. Data were pooled using random-effects models. Results: A total of 11 RCTs (n = 62,431) were included in our systematic review; 4 examined dalcetrapib (n = 16,612), 6 anacetrapib (n = 33,682), and 1 evacetrapib (n = 12,092). Compared to dalcetrapib, ana-cetrapib and evacetrapib were more efficacious at raising HDL-c levels (similar to 100-130 vs. similar to 30%). Anacetrapib and evacetrapib also decreased low-density lipoprotein cholesterol (LDL-c) by approximately 30% while dalcetrapib did not affect the LDL-c level. Overall, CETP inhibitors were not associated with the incidence of MACE (pooled relative risk [RR]: 0.97; 95% confidence interval [CI]: 0.91-1.04). CETP inhibitors may decrease the risks of nonfatal myocardial infarction (MI) (RR: 0.93; 95% CI: 0.87-1.00) and cardiovascular death (RR: 0.92; 95% CI: 0.83-1.01), though these trends did not reach statistical significance. Conclusions: CETP inhibitors are not associated with an increased risk of MACE or all-cause mortality. There is a trend towards small reductions in nonfatal MI and cardiovascular death, though the clinical im-portance of such reductions is likely modest.
机译：背景：胆汁纤维酯转移蛋白（CETP）抑制剂增加血清高密度脂蛋白胆固醇（HDL-C）浓度;然而，它们对心血管结果的影响尚不清楚。这种系统综述检测CETP抑制剂对血清脂质谱，心血管事件和全因死亡率的影响。方法：我们搜索了安慰剂控制随机对照试验（RCT）的临床试验中的临床试验中的Cochrane文库，该试验检查了CETP抑制剂（Dalcetrapia，Anacetrapib，Evacetrapib或Ta-8995）对所有原因死亡率的影响，主要的不良心血管事件（立柱），或术术的组分> = 6个月。使用随机效果模型汇集数据。结果：我们的系统审查中共有11个RCT（n = 62,431）; 4检查Dalcetrapib（n = 16,612），6个anacetrapib（n = 33,682），1 evacetrapib（n = 12,092）。与Dalcetrapia相比，Ana-Cetrapib和Evacetrapib在提高HDL-C水平时更有效（类似于100-130 Vs.类似于30％）。 Anacetrapib和Evacetrapib还将低密度脂蛋白胆固醇（LDL-C）降低约30％，而Dalcetrapib不影响LDL-C水平。总体而言，CETP抑制剂与旋转术的发生率无关（合并的相对风险[RR]：0.97; 95％置信区间[CI]：0.91-1.04）。 CETP抑制剂可能会降低非致癌心肌梗死的风险（MI）（RR：0.93; 95％CI：0.87-1.00）和心血管死亡（RR：0.92; 95％CI：0.83-1.01），但这些趋势没有达到统计数据意义。结论：CETP抑制剂与术士或全导致死亡率的风险增加无关。虽然这种减少的临床可执行，但缺乏缺乏态度和心血管死亡的趋势可能适度。

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