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Related Experiment Video

Updated: Jun 6, 2026

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
09:15

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles

Published on: November 10, 2017

Are post-treatment low-density lipoprotein subclass pattern analyses potentially misleading?

Harold Bays1, Scott Conard, Lawrence A Leiter

  • 1Louisville Metabolic and Atherosclerosis Research Center, Louisville, KY, USA. hbaysmd@aol.com

Lipids in Health and Disease
|December 2, 2010
PubMed
Summary

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Escalating cholesterol therapy with ezetimibe or higher atorvastatin doses effectively lowers LDL-C and atherogenic particles. However, relying solely on LDL particle size (Pattern B) for risk assessment may be misleading.

Area of Science:

  • Cardiology
  • Lipidology
  • Pharmacology

Background:

  • Cholesterol-lowering therapies can alter LDL particle size, potentially misrepresenting cardiovascular risk.
  • Assessing atherosclerotic coronary heart disease (CHD) risk requires a comprehensive lipid profile analysis.
  • This study investigated the impact of intensified statin therapy on lipid parameters.

Purpose of the Study:

  • To compare the effects of adding ezetimibe to atorvastatin versus doubling atorvastatin dose on LDL-C, LDL particle number, and LDL particle size.
  • To evaluate lipid changes in hypercholesterolemic patients at high risk for atherosclerotic CHD.
  • To analyze treatment effects across different baseline triglyceride levels.

Main Methods:

  • Multicenter, double-blind, randomized, parallel-group study.

Related Experiment Videos

Last Updated: Jun 6, 2026

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
09:15

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles

Published on: November 10, 2017

  • 579 hypercholesterolemic patients randomized to ezetimibe + atorvastatin 40 mg or atorvastatin 80 mg for 6 weeks.
  • Lipoprotein subclasses analyzed using Vertical Auto Profile II.

    • Main Results:

    • Both treatment strategies significantly reduced LDL-C, apolipoprotein B, and non-HDL-C.
    • Neither treatment reduced the proportion of small, dense LDL particles (Pattern B); this proportion numerically increased.
    • Results were consistent across subgroups with baseline triglyceride levels <150 mg/dL or ≥150 mg/dL.

    Conclusions:

    • Elevated Pattern B alone can be a misleading indicator of CHD risk when interpreting intensified cholesterol-lowering therapy.
    • Comprehensive assessment of LDL-C, atherogenic lipoprotein particle concentration, and non-HDL-C is crucial.
    • Lipid-lowering therapy effects should be evaluated holistically, not solely on LDL particle size changes.