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 .
Effects of pravastatin treatment on lipoprotein subclass profiles and particle size in the PLAC-I trial.
Lipoprotein subclass analyses may facilitate coronary heart disease ( CHD ) risk stratification and provide insight into the cardioprotective benefits of statins ( 3-hydroxymethylglutaryl-coenzyme A reductase inhibitors ) . This study evaluated the influence of pravastatin on lipoprotein subclass profiles to determine whether subjects with predominantly large LDL ( LDL size > 20.5 nm ) or small LDL ( LDL size < or = 20.5 nm ) at baseline differ in responsiveness to drug treatment . Frozen plasma specimens were analyzed from a subset of participants in the Pravastatin Limitation of Atherosclerosis in the Coronaries ( PLAC-I ) trial at baseline and after treatment for 6 months with pravastatin ( n=154 ) or placebo ( n=138 ) .  Lipids were measured by st and ard chemical methods and lipoprotein subclasses by nuclear magnetic resonance ( NMR ) spectroscopy .  Pravastatin-induced changes in lipid levels were similar in subjects with large or small LDL at baseline . Levels of the most abundant LDL subclass were preferentially lowered by pravastatin , result ing in an increase in average LDL size for those with a predominance of small LDL . High-risk CHD subjects with small LDL particles gain at least as much pharmacological benefit from pravastatin as those with large LDL , as evidence d by reductions in the numbers of total and small LDL particles , and increases in average LDL and HDL particle size
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 .