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 .
Low-Density Lipoprotein Particle Concentration and Size as Determined by Nuclear Magnetic Resonance Spectroscopy as Predictors of Cardiovascular Disease in Women
Background —Nuclear magnetic resonance ( NMR ) offers an alternative , spectroscopic means of quantifying LDL and of measuring LDL particle size . Methods and Results —We conducted a prospect i ve nested case-control study among healthy middle-aged women to assess  LDL particle size ( NMR ) and concentration ( NMR )  as risk factors for future myocardial infa rct ion , stroke , or death of coronary heart disease . Median baseline levels of LDL particle concentration ( NMR ) were higher ( 1597 vs 1404 nmol/L;P = 0.0001 ) and LDL particle size ( NMR ) was lower ( 21.5 vs 21.8 nm;P = 0.046 ) among women who subsequently had cardiovascular events ( n=130 ) than among those who did not ( n= 130 ) . Of these 2 factors , LDL particle concentration (  NMR ) was the stronger predictor ( relative risk for the highest compared with the lowest quartile=4.17 , 95 % CI 1.96–8.87 ) . This compared with a relative risk of 3.11 ( 95 % CI 1.55–6.26 ) for the ratio of total cholesterol to HDL cholesterol and a relative risk of 5.91 ( 95 % CI 2.65–13.15 ) for C-reactive protein . The areas under the receiver operating characteristic curves for LDL particle concentration ( NMR ) , total cholesterol to HDL cholesterol ratio , and C-reactive protein were 0.64 , 0.64 , and 0.66 , respectively . LDL particle concentration ( NMR ) correlated with several traditionally assessed lipid and nonlipid risk factors , and thus adjustment for these tended to attenuate the magnitude of association between LDL particle concentration ( NMR ) and risk . Conclusions —In this cohort , LDL particle concentration measured by NMR spectroscopy was a predictor of future cardiovascular risk . However , the magnitude of predictive value of LDL particle concentration  ( NMR ) was not substantively different from that of the total cholesterol to HDL cholesterol ratio and was less than that of C-reactive protein
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 .