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 .
Icosapent ethyl, a pure EPA omega-3 fatty acid: effects on lipoprotein particle concentration and size in patients with very high triglyceride levels (the MARINE study).
BACKGROUND Icosapent ethyl ( IPE ; formerly AMR101 ) is a high-purity prescription form of eicosapentaenoic acid ethyl ester . In the MARINE study we evaluated the efficacy and safety of IPE in patients with very high triglycerides ( TG ; ≥500 mg/dL ) and previously demonstrated significant reductions in TG levels with no significant increases in low-density lipoprotein ( LDL ) cholesterol levels  . OBJECTIVES In this follow-up , exploratory analysis , we report the effects of IPE on lipoprotein particle concentration and size . METHODS MARINE was a phase 3 , multicenter , placebo-controlled , r and omized , double-blind , 12-week study . Hypertriglyceridemic patients ( N = 229 ) were r and omized to three treatment groups : IPE 4 g/day , IPE 2 g/day , or placebo . Lipoprotein particle concentrations and sizes were measured by nuclear magnetic resonance spectroscopy . RESULTS Compared with placebo , IPE 4 g/day significantly reduced median concentrations of large very-low-density lipoprotein ( VLDL ; -27.9 % ; P = .0211 ) , total LDL ( -16.3 % ; P = .0006 ) , small LDL ( -25.6 % ; P < .0001 ) , and total high-density lipoprotein ( HDL ; -7.4 % ; P = .0063 ) particles and reduced VLDL particle size ( -8.6 % ; P = .0017 ) . In this patient population with TG ≥500 mg/dL , IPE did not significantly change the overall sizes of LDL or HDL particles . CONCLUSION IPE 4 g/day significantly reduced large VLDL , total LDL , small LDL , and total HDL particle concentrations and VLDL particle size in patients with TG ≥500 mg/dL. Changes in VLDL particle concentration and size reflect the TG-lowering effects of eicosapentaenoic acid . The reduction in LDL particle concentration  with IPE is novel among ω-3 therapies and is consistent with the previously reported reduction in apolipoprotein B and lack of LDL-C increase with IPE in patients with very high TG levels . CLINICAL TRIAL REGISTRATION NUMBER NCT01047683
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 .