Peter Attia· MD
so you had this drug triparanol that inhibited that enzyme and lo and behold it lowered cholesterol now this was for the listener this is back in the day before we knew anything about the sub-fractions of cholesterol so we just knew from some of the early work of Ansel keys but if you looked at very very high levels of total cholesterol and compared that to people who had very very low levels of total cholesterol there was a difference in outcome cardiovascular outcomes this was an observed finding there was no intervention to test that so this drug came along and it really lowered total cholesterol and it likely would have been lowering LDL cholesterol and apob it basically got approved on the basis of that without of course the hard outcome so it gets approved it goes into circulation and it's really only after it was approved gosh probably what eight to ten years later that they had enough post surveillance data to say you know what this drug is lowering cholesterol all right but it's actually increasing mortality cardiovascular mortality drug was pulled off the market