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LDL Particle Number and Risk of Future Cardiovascular Disease in the Framingham Offspring Study - Implications for

William C Cromwell1, James D Otvos, Michelle J Keyes

  • 1Division of Lipoprotein Disorders, Presbyterian Center for Preventive Cardiology, Charlotte, NC.

Journal of Clinical Lipidology
|August 7, 2009
PubMed

Insights

Low LDL particle number (LDL-P) indicates lower cardiovascular disease (CVD) risk than LDL cholesterol (LDL-C) or non-HDL cholesterol. LDL-P may be a better measure for managing CVD risk and LDL-lowering treatment effectiveness.

Area of Science:

  • Cardiology
  • Biochemistry
  • Epidemiology

Background:

  • LDL cholesterol (LDL-C) variability creates discrepancies with LDL particle number (LDL-P).
  • Assessing residual cardiovascular disease (CVD) risk and LDL-lowering treatment efficacy using LDL-C is uncertain.
  • Current therapeutic targets for LDL levels are being re-evaluated.

Purpose of the Study:

  • To compare LDL-P, LDL-C, and non-HDL cholesterol (non-HDL-C) for CVD risk discrimination.
  • To assess the utility of alternative LDL measures at low levels relevant to current therapeutic targets.

Main Methods:

  • LDL-C and non-HDL-C were chemically measured; LDL-P and VLDL particle number (VLDL-P) were measured by NMR.
  • Study included 3066 middle-aged participants without CVD from the Framingham Offspring cohort.
  • Primary outcome was the incidence of first CVD event over a median follow-up of 14.8 years.

Main Results:

  • LDL-P showed a stronger association with future CVD in both sexes compared to LDL-C or non-HDL-C.
  • Individuals with low LDL-P (<25th percentile) had a significantly lower CVD event rate.
  • Low LDL-P was a more sensitive indicator of reduced CVD risk than equivalent low levels of LDL-C or non-HDL-C.

Conclusions:

  • LDL particle number (LDL-P) is a more sensitive indicator of low CVD risk than LDL-C or non-HDL-C.
  • LDL-P may have a valuable clinical role in guiding LDL management strategies.
  • Findings suggest LDL-P could be a target for optimizing CVD risk reduction.
Abstract

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