"Do we know how Apabatalone fares with respect to lowering non-HDL cholesterol levels? I have read elsewhere that any significant improvement in non-HDL likely means significant reduction in heart attack risk."
Apabetalone effects on non-HDL cholesterol? In the Atherosclerosis peer-reviewed article from 2016 (news released here) and indexed on PubMed here, Table I summarizes the effects of apabetalone on lipoproteins in the pooled SUSTAIN and ASSURE trials. Both apabetalone and placebo groups experienced a ~10% decrease in their baseline LDL-cholesterol levels after ~6 months of treatment. There was no significant difference in LDL-cholesterol levels between the apabetalone and placebo groups. Keep in mind both groups were on statin therapy already.
As for lowering non-HDL cholesterol (i.e. LDL-cholesterol) and its effects on cardiovascular events......take a look at the recently published FOURIER PCSK9 antibody trial "Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease." These patients were already on an "optimized regimen of lipid-lowering therapy, which was defined as preferably a high-intensity statin but must have been at least atorvastatin at a dose of 20 mg daily or its equivalent, with or without ezetimibe." This Evolocumab (aka Repatha) therapy dropped baseline LDL-cholesterol from by ~56 mg/dL, reducing baseline levels of 92 mg/dL to ~36 mg/dL. That is a HUGE effect. This dramatic drop in LDL-cholesterol reduced 3-point MACE (heart attack, stroke, cardiovascular death) by 20%. Break this down further and one sees that heart attacks were significantly reduced by 27%, strokes were significantly reduced by 21%, and cardiovascular death was non-significantly increased by 5%.
So long story short....it is quite possible that the modest effects of the CETP inhibitor anacetrapib on reducing heart attack (13% significant reduction in heart attack, non-significant 8% reduction in cardiovascular death, no effect on stroke; see NEJM article) are due to the effect of anacetrapib to lower LDL-cholesterol by 17 mg/dL in the REVEAL study and has nothing to do with the increase of HDL by anacetrapib.
BearDownAZ
