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This analysis of the ACCELERATE study investigated the effects of the cholesteryl ester transfer protein (CETP) inhibitor evacetrapib on major adverse cardiovascular outcomes in patients with high-risk vascular disease. 12,092 patients with an ACS within the previous 30–365 days, cerebrovascular atherosclerotic disease, peripheral vascular arterial disease, or diabetes mellitus with coronary artery disease were randomised to receive evacetrapib 130mg daily or matching placebo in addition to standard medical therapy. The primary efficacy end- point was the first occurrence of any component of the composite of death from cardiovascular causes, MI, stroke, coronary revascularisation, or hospitalisation for unstable angina. After a median of 26 months’ treatment, a primary end-point event had occurred in 12.9% of evacetrapib recipients and 12.8% of placebo recipients (p=0.91). The trial was terminated prematurely by the data and safety monitoring board because of a lack of efficacy. Although there were substantial lipid changes with the CETP inhibitor evacetrapib, these did not translate into a reduction in cardiovascular events in the ACCELERATE trial, which was discontinued on the grounds of futility rather than safety. This is in keeping with the dalcetrapib programme, which was also stopped on these grounds. However, subgroup analysis from the dal-OUTCOMES study suggests that patients with a polymorphism in the ADCY9 gene may benefit from dalcetrapib therapy, and this is currently being studied in a large outcome trial. The REVEAL trial with anacetrapib continues and will report soon, but I would not be optimistic about a positive result given the previous trials.