Small LDL-cholesterol is superior to LDL-cholesterol for determining severe coronary atherosclerosis.
OBJECTIVE
Recent evidence suggests that small dense low-density lipoprotein (sd-LDL) particles are more atherogenic than large-LDL in spite of their lower cholesterol content. This study aimed to determine whether sd-LDL-cholesterol (sd-LDL-C) is superior to LDL-C as a biomarker of coronary heart disease (CHD).


METHODS
LDL particle size determined by gradient gel electrophoresis and sd-LDL-C concentrations quantified by heparin-magnesium precipitation were compared between 482 stable CHD patients and 389 non-diabetic subjects without CHD who were not receiving any lipid-lowering drugs.


RESULTS
Both male and female CHD patients had significantly smaller LDL particles and lower large-LDL-C concentrations (estimated by subtracting the sd-LDL-C concentration from the LDL-C concentration), and significantly higher sd-LDL-C concentrations than the control subjects. LDL-C concentrations were modestly higher and sd-LDL-C concentrations were significantly higher in 258 patients with angiographically documented severe CHD than in the patients with mild CHD irrespective of treatment by LDL-lowering drugs and history of myocardial infarction and/or coronary revascularization. Large-LDL-C concentrations, in contrast, were similar between the two groups. Multivariate logistic regression analysis revealed that sd-LDL-C levels were significantly associated with severe CHD independently of LDL-C.


CONCLUSIONS
sd-LDL-C levels are more powerful than LDL-C levels for the determination of severe stable CHD.
Koba
Shinji
S
Department of Medicine, Division of Cardiology, Showa University School of Medicine, tokyo, Japan. skoba@med.showa-u.ac.jp
Yokota
Yuuya
Y
Hirano
Tsutomu
T
Ito
Yasuki
Y
Ban
Yoshihisa
Y
Tsunoda
Fumiyoshi
F
Sato
Takatoshi
T
Shoji
Makoto
M
Suzuki
Hiroshi
H
Geshi
Eiichi
E
Kobayashi
Youichi
Y
Katagiri
Takashi
T
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis*; D003327:Coronary Disease / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010316:Particle Size
D015415:Biomarkers; D008078:Cholesterol, LDL