[PMID]: | 28729361 |
[Au] Autor: | Thomas T; Zhou H; Karmally W; Ramakrishnan R; Holleran S; Liu Y; Jumes P; Wagner JA; Hubbard B; Previs SF; Roddy T; Johnson-Levonas AO; Gutstein DE; Marcovina SM; Rader DJ; Ginsberg HN; Millar JS; Reyes-Soffer G |
[Ad] Endereço: | From the Columbia University, New York (T.T., W.K., R.R., S.H., H.N.G., G.R.-S.); Merck & Co, Inc, Kenilworth, NJ (H.Z., Y.L., P.J., J.A.W., B.H., S.F.P., T.R., A.O.J.-L., D.E.G.); University of Washington, Seattle (S.M.M.); and University of Pennsylvania, Philadelphia (D.J.R., J.S.M.). |
[Ti] Título: | CETP (Cholesteryl Ester Transfer Protein) Inhibition With Anacetrapib Decreases Production of Lipoprotein(a) in Mildly Hypercholesterolemic Subjects. |
[So] Source: | Arterioscler Thromb Vasc Biol;37(9):1770-1775, 2017 Sep. |
[Is] ISSN: | 1524-4636 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | OBJECTIVE: Lp(a) [lipoprotein (a)] is composed of apoB (apolipoprotein B) and apo(a) [apolipoprotein (a)] and is an independent risk factor for cardiovascular disease and aortic stenosis. In clinical trials, anacetrapib, a CETP (cholesteryl ester transfer protein) inhibitor, causes significant reductions in plasma Lp(a) levels. We conducted an exploratory study to examine the mechanism for Lp(a) lowering by anacetrapib. APPROACH AND RESULTS: We enrolled 39 participants in a fixed-sequence, double-blind study of the effects of anacetrapib on the metabolism of apoB and high-density lipoproteins. Twenty-nine patients were randomized to atorvastatin 20 mg/d, plus placebo for 4 weeks, and then atorvastatin plus anacetrapib (100 mg/d) for 8 weeks. The other 10 subjects were randomized to double placebo for 4 weeks followed by placebo plus anacetrapib for 8 weeks. We examined the mechanisms of Lp(a) lowering in a subset of 12 subjects having both Lp(a) levels >20 nmol/L and more than a 15% reduction in Lp(a) by the end of anacetrapib treatment. We performed stable isotope kinetic studies using H -leucine at the end of each treatment to measure apo(a) fractional catabolic rate and production rate. Median baseline Lp(a) levels were 21.5 nmol/L (interquartile range, 9.9-108.1 nmol/L) in the complete cohort (39 subjects) and 52.9 nmol/L (interquartile range, 38.4-121.3 nmol/L) in the subset selected for kinetic studies. Anacetrapib treatment lowered Lp(a) by 34.1% ( ≤0.001) and 39.6% in the complete and subset cohort, respectively. The decreases in Lp(a) levels were because of a 41% reduction in the apo(a) production rate, with no effects on apo(a) fractional catabolic rate. CONCLUSIONS: Anacetrapib reduces Lp(a) levels by decreasing its production. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00990808. |
[Mh] Termos MeSH primário: |
Anticolesterolemiantes/uso terapêutico Proteínas de Transferência de Ésteres de Colesterol/antagonistas & inibidores Hipercolesterolemia/tratamento farmacológico Lipoproteína(a)/sangue Oxazolidinonas/uso terapêutico
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[Mh] Termos MeSH secundário: |
Adulto Idoso Anticolesterolemiantes/efeitos adversos Biomarcadores/sangue Proteínas de Transferência de Ésteres de Colesterol/metabolismo Cromatografia Líquida Método Duplo-Cego Regulação para Baixo Feminino Seres Humanos Hipercolesterolemia/sangue Hipercolesterolemia/diagnóstico Masculino Meia-Idade Cidade de Nova Iorque Oxazolidinonas/efeitos adversos Pennsylvania Índice de Gravidade de Doença Espectrometria de Massas em Tandem Fatores de Tempo Resultado do Tratamento
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[Pt] Tipo de publicação: | JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL |
[Nm] Nome de substância:
| 0 (Anticholesteremic Agents); 0 (Biomarkers); 0 (CETP protein, human); 0 (Cholesterol Ester Transfer Proteins); 0 (Lipoprotein(a)); 0 (Oxazolidinones); P7T269PR6S (anacetrapib) |
[Em] Mês de entrada: | 1709 |
[Cu] Atualização por classe: | 170907 |
[Lr] Data última revisão:
| 170907 |
[Sb] Subgrupo de revista: | IM |
[Da] Data de entrada para processamento: | 170722 |
[St] Status: | MEDLINE |
[do] DOI: | 10.1161/ATVBAHA.117.309549 |
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