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 .
Extended-release niacin reduces LDL particle number without changing total LDL cholesterol in patients with stable CAD.
BACKGROUND The importance of the number of circulating low-density lipoprotein ( LDL ) cholesterol particles , in addition to total LDL level , has been increasingly recognized . The effects of extended-release niacin ( ERN ) on LDL particle numbers have not been studied . OBJECTIVE To evaluate ERN 's effects on LDL particle numbers . METHODS Fifty-four patients with stable coronary artery disease ( CAD ) and well-controlled LDL levels were r and omly assigned to 3 months of ERN ( 1 g/day ) or placebo in addition to their baseline medications . Lipoprotein particle number was analyzed by proton nuclear magnetic resonance spectroscopy at baseline and after 3 months . RESULTS Compared to baseline , the addition of ERN had no significant effect on total LDL cholesterol levels ; however , ERN decreased the number of medium and small LDL particles ( P < .005 ) . After 3 months , ERN decreased the number of medium and small LDL particles compared to placebo-treated patients ( P < .05 ) . ERN raised HDL cholesterol levels by 2.7 % , significantly increased the number of large HDL particles ( P < .001 ) , and decreased the number of small HDL particles ( P = .027 ) compared to placebo . There were no significant changes in lipid values or particle numbers in the placebo-treated patients . In patients with stable coronary artery disease and well-controlled LDL cholesterol levels , ERN reduced the number of circulating particles of the more atherogenic subtypes of LDL , despite having no effect on total LDL cholesterol levels .  ERN also favorably altered the number of HDL particles . CONCLUSION ERN-induced alterations in lipoprotein particle numbers may contribute to its anti-atherosclerotic effects , and these effects may not be evident from the st and ard lipid profile
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 .