Conclusions Study -level data from this systemic review establish that different lipid lowering agents can lead to discordance between LDL-P and LDL-C , therefore , basing LDL-lowering therapy only on the achievement of cholesterol goals may result in a treatment gap .
Therefore , the use of LDL-P for monitoring lipid-lowering therapy , particularly for statins , can provide a more accurate assessment of residual cardiovascular risk
Purpose This systematic review was performed to summarize published experience using low density lipoprotein particle number ( LDL-P ) to monitor the efficacy of  lipid-lowering pharmacotherapies .
Relations of lipoprotein subclass levels and low-density lipoprotein size to progression of coronary artery disease in the Pravastatin Limitation of Atherosclerosis in the Coronary Arteries (PLAC-I) trial.
Lipoprotein subclass measurements may enhance the prediction of coronary artery disease ( CAD ) risk , but clinical application of such information has been hindered by the relatively laborious and time-consuming nature of laboratory measurement methods . In this study , lipoprotein subclass analyses were performed on frozen plasma sample s from 241 participants in the Pravastatin Limitation of Atherosclerosis in the Coronary arteries Trial using an automated nuclear magnetic resonance technique . The objective was to determine if levels of these subclasses provided additional information on the progression of CAD , based on the change in the minimum lumen diameter , over a 3-year period . After adjustment for race , sex , age , treatment group , baseline lumen diameter , and chemically measured levels of triglycerides , low-density lipoprotein ( LDL ) cholesterol , and high-density lipoprotein ( HDL ) cholesterol , on-trial predictors ( p < 0.05 ) of progression included an elevated LDL particle number , and levels of small LDL and small HDL . Within treatment groups , CAD progression was most strongly related to the LDL particle number  ( placebo ) and levels of small HDL  ( pravastatin ) . In logistic regression models that adjusted for chemically determined lipid levels and other covariates , a small LDL level > or = 30 mg/dl ( median ) was associated with a ninefold increased risk of CAD progression ( p < 0.01 ) in the placebo group . These results indicate that levels of various lipoprotein subclasses may provide useful information on CAD risk even if levels of traditional risk factors are known
Conclusions Study -level data from this systemic review establish that different lipid lowering agents can lead to discordance between LDL-P and LDL-C , therefore , basing LDL-lowering therapy only on the achievement of cholesterol goals may result in a treatment gap .
Therefore , the use of LDL-P for monitoring lipid-lowering therapy , particularly for statins , can provide a more accurate assessment of residual cardiovascular risk
Purpose This systematic review was performed to summarize published experience using low density lipoprotein particle number ( LDL-P ) to monitor the efficacy of  lipid-lowering pharmacotherapies .