%0 Journal Article
%T Are post-treatment low-density lipoprotein subclass pattern analyses potentially misleading?
%A Harold Bays
%A Scott Conard
%A Lawrence A Leiter
%A Steven Bird
%A Erin Jensen
%A Mary E Hanson
%A Arvind Shah
%A Andrew M Tershakovec
%J Lipids in Health and Disease
%D 2010
%I BioMed Central
%R 10.1186/1476-511x-9-136
%X Both treatments significantly reduced LDL-C (and the cholesterol content of most LDL subfractions [LDL1-4]) apolipoprotein B, non-HDL-C levels, but did not reduce the proportion of smaller, more dense LDL particles; in fact, the proportion of Pattern B was numerically increased. Results were generally similar in patients with triglyceride levels <150 or ¡Ý150 mg/dL.When assessing the effects of escalating cholesterol-lowering therapy, effects upon Pattern B alone to assess coronary heart disease risk may be misleading when interpreted without considerations of other lipid effects, such as reductions in LDL-C, atherogenic lipoprotein particle concentration, and non-HDL-C levels.(Registered at clinicaltrials.gov: Clinical trial # NCT00276484)Landmark CHD outcomes trials demonstrate that, in general, LDL-C lowering therapies reduce CHD risk. Statin-treated patients who achieve greater LDL-C lowering (either through an increase in the same statin dose or through use of a different statin) have reduced CHD events compared with statin-treated patients with less LDL-C lowering[1-3]. In addition, non-high-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein B (apo B) may be better predictors of CHD risk than LDL-C levels[4]. Non-HDL-C is a measure of the cholesterol carried by all atherogenic lipoproteins, such as the cholesterol carried by LDL particles, as well as the cholesterol carried by very low-density lipoproteins, intermediate-density lipoproteins, remnant lipoproteins, chylomicrons (and their remnants), and lipoprotein (a). Regarding particle number, one apo B molecule is found on each lipoprotein particle; thus, apo B level is often considered a surrogate marker for atherogenic lipoprotein particle concentration. An increase in atherogenic lipoprotein particle number is thought to increase CHD risk[5,6].Lipoprotein particle size is another lipid parameter that may influence CHD risk. A disproportionate increase in smaller LDL particles is often described
%U http://www.lipidworld.com/content/9/1/136