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 .
The effect of atorvastatin on serum lipids, lipoproteins and NMR spectroscopy defined lipoprotein subclasses in type 2 diabetic patients with ischaemic heart disease.
The effect of statin therapy on subclasses of LDL , VLDL and HDL lipoproteins is unclear . We compared changes in serum lipids , apolipoproteins and nuclear magnetic resonance ( NMR ) spectroscopy measured lipoprotein subclass concentration and average particle size over a minimum 6 months treatment period of atorvastatin 10 mg vs. placebo in 122 men and women . All subjects had type 2 diabetes and a modest dyslipidaemia ( mean LDL-cholesterol 3.2 mmol/l and median triglycerides 1.8 mmol/l ) and had a previous myocardial infa rct ion . Compared with placebo , atorvastatin therapy was associated with a greater decrease in medium VLDL ( median within person change -13.4 vs. -5.9 nmol/l , P<0.001 adjusted for baseline level ) , small VLDL ( median change -17.8 vs. -8.1 nmol/l , P=0.002 ) , large LDL ( mean within person change -167.9 vs. -48.6 nmol/l , P<0.001 ) and medium LDL ( median within person change -101.8 vs. -22.3 nmol/l , P=0.017 ) . Atorvastatin therapy was also associated with a greater increase in large HDL than placebo ( median change 1.40 vs. 0.80 micromol/l , P=0.02 ) and there was little change in small HDL so that average HDL particle size increased significantly with atorvastatin ( P=0.04 ) . In addition to reducing levels of ( enzymatically measured ) triglyceride , LDL-cholesterol and apolipoprotein B in diabetic patients , atorvastatin significantly reduces NMR measured medium and small VLDL and large and medium LDL , and increases large HDL
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 .