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 .
Comparisons of effects of statins (atorvastatin, fluvastatin, lovastatin, pravastatin, and simvastatin) on fasting and postprandial lipoproteins in patients with coronary heart disease versus control subjects.
The effects of atorvastatin at 20 , 40 , and 80 mg/day on plasma lipoprotein subspecies were examined in a r and omized , placebo-controlled fashion over 36 weeks in 97 patients with coronary heart disease ( CHD ) with low-density lipoprotein ( LDL ) cholesterol levels of > 130 mg/dl and compared directly with the effects of fluvastatin ( n = 28 ) , pravastatin ( n = 22 ) , lovastatin ( n = 24 ) , and simvastatin ( n = 25 ) . The effects of placebo and 40 mg/day of each statin were also examined in subjects with CHD with subjects in the fasting state and in the fed state 4 hours after a meal rich in saturated fat and cholesterol and compared with results in age- and gender-matched control subjects . At all doses tested in the fasting and fed states , atorvastatin was significantly ( p < 0.01 ) more effective in lowering LDL cholesterol and non-high-density lipoprotein ( HDL ) cholesterol than all other statins , and significantly ( p < 0.05 ) more effective than all statins , except for simvastatin , in lowering triglyceride and remnant lipoprotein ( RLP ) cholesterol . At 40 mg/day in the fasting state , atorvastatin was significantly ( p < 0.01 ) more effective than all statins , except for lovastatin and simvastatin , in lowering cholesterol levels in small LDL , and was significantly ( p < 0.05 ) more effective than all statins , except for simvastatin , in increasing cholesterol in large HDL and in lowering LDL particle numbers . Our data indicate that atorvastatin was the most effective statin tested in lowering cholesterol in LDL , non-HDL , and RLP in the fasting and fed states , and getting patients with CHD to established goals , with fluvastatin , pravastatin , lovastatin , and simvastatin having about 33 % , 50 % , 60 % , and 85 % of the efficacy of atorvastatin , respectively , at the same dose in the same patients
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 .