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 .
A randomized trial of the effects of atorvastatin and niacin in patients with combined hyperlipidemia or isolated hypertriglyceridemia. Collaborative Atorvastatin Study Group.
BACKGROUND To assess the lipid-lowering effects and safety of atorvastatin and niacin in patients with combined hyperlipidemia or isolated hypertriglyceridemia . METHODS We performed a r and omized , open-label , parallel- design , active-controlled , study in eight centers in the United States . We enrolled 108 patients with total cholesterol ( TC ) of > or = 200 mg/dL , serum triglycerides ( TG ) > or = 200 and < or = 800 mg/dL , and apolipoprotein B ( apo B ) > or = 110 mg/dL. Patients were r and omly assigned to receive atorvastatin 10 mg once daily ( n=55 ) or immediate-release niacin 1 g three times daily for 12 weeks ( n=53 ) . Patients were stratified based on low-density lipoprotein cholesterol ( LDL-C ) : Patients with LDL-C > or = 135 mg/dL were considered to have combined hyperlipidemia and patients with LDL-C < 135 mg/dL were considered to have isolated hypertriglyceridemia . The primary outcome measure was percent change from baseline in LDL-C. Other lipid levels were evaluated as secondary parameters . RESULTS Atorvastatin reduced LDL-C 30 % and TC 26 % from baseline , and increased high-density lipoprotein cholesterol ( HDL-C ) 4 % . Total TG were reduced 17 % . Niacin reduced LDL-C 2 % , TC 7 % , increased HDL-C 25 % , and reduced total TG 29 % from baseline . There was a significant difference in LDL-C reduction , the primary efficacy parameter , between the two treatment groups ( P < 0.05 , favoring atorvastatin ) , as well as a significant difference in the improvement in HDL-C ( P < 0.05 , favoring niacin ) . The effect of atorvastatin was relatively consistent between patients with combined hyperlipidemia and isolated hypertriglyceridemia , whereas there was more variability between these strata in the niacin treatment group . Atorvastatin was better tolerated than niacin . CONCLUSION Atorvastatin may allow patients with combined hyperlipidemia to be treated with monotherapy and offers an efficacious and well-tolerated alternative to niacin for the treatment of patients with isolated hypertriglyceridemia
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 .