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Updated: Jun 4, 2026

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
[Beyond lowering LDL cholesterol]
Ozgür Bayturan1, Ozan Utük, E Murat Tuzcu
1Celal Bayar Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Manisa, Türkiye. bayturanoz@hotmail.com
Insights
Lowering low-density lipoprotein cholesterol (LDL-C) reduces vascular events, but residual risks persist. Identifying factors like inflammation and diabetes is key to further prevention.
Area of Science:
- Cardiology
- Vascular Medicine
- Preventive Cardiology
Background:
- Randomized controlled studies confirm the importance of lowering low-density lipoprotein cholesterol (LDL-C) for preventing vascular events.
- A significant number of patients experience residual vascular events despite achieving low LDL-C levels.
- The factors contributing to this residual risk require further investigation.
Purpose of the Study:
- To review and discuss the significance of identifying residual risk factors for vascular events.
- To explore novel treatment strategies aimed at further reducing vascular events.
- To highlight the role of arterial wall imaging in assessing therapeutic efficacy.
Main Methods:
- Literature review of randomized controlled studies and recent data.
- Analysis of emerging factors impacting residual vascular risk.
- Discussion of diagnostic and therapeutic implications.
Main Results:
- Residual vascular risk is influenced by factors beyond LDL-C, including inflammatory mediators, non-high-density lipoprotein (HDL) cholesterol, apolipoprotein B, small dense LDL-C, type 2 diabetes mellitus, and lifestyle.
- These factors represent potential targets for intervention.
- Arterial wall imaging is presented as a valuable tool for evaluating treatment effectiveness.
Conclusions:
- Identifying and managing residual risk factors is crucial for comprehensive vascular event prevention.
- New therapeutic strategies targeting these factors are needed.
- Arterial wall imaging aids in optimizing treatment protocols for cardiovascular health.
Abstract:
Compelling evidence from randomized controlled studies demonstrated the crucial role of lowering low-density lipoprotein cholesterol (LDL-C) in the prevention of vascular events. However, not all patients with low LDL-C levels show similar reduction in event rates. The residual risk factors associated with ongoing vascular events despite achieving low LDL-C levels remain to be elucidated. New data suggest that beyond statin therapy, inflammatory mediators, high non-HDL (high-density lipoprotein) cholesterol or apolipoprotein B, small dense LDL-C, type 2 diabetes mellitus, and lifestyle features may have impact on residual vascular risk. In this review, we discussed the significance of identifying these residual risk factors and developing new treatment strategies to further decrease vascular events. The importance of imaging arterial wall to evaluate the effect of various medical therapies has also stated.
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