title: Small dense LDL cholesterol is a robust therapeutic marker of statin treatment in patients with acute coronary syndrome and metabolic syndrome.
abstract: BACKGROUND
  Small dense low-density lipoprotein (sd-LDL) is an atherogenic LDL subfraction and often increased in metabolic syndrome (MetS). This study aimed to determine whether sd-LDL cholesterol (sd-LDL-C) is a therapeutic marker of statin treatment in patients with acute coronary syndrome (ACS) and MetS.
  
  
  METHODS
  We examined 71 patients with ACS and 50 non-ACS subjects with normal coronary arteries (controls). The patients with ACS were treated with life-style modifications (n=36) or those plus 20mg atorvastatin daily (n=35) for 6 months. We measured sd-LDL-C by a novel detergent-based homogenous assay and calculated buoyant LDL-C (b-LDL-C).
  
  
  RESULTS
  The patients with ACS had higher sd-LDL-C than did the controls (30±14 vs. 22±8 mg/dl, p<0.001). Furthermore, sd-LDL-C was higher in the patients with ACS and MetS (n=31) than in those without MetS (n=40) (35±17 vs. 27±11 mg/dl, p<0.05). Atorvastatin reduced LDL-C and sd-LDL-C by 31% (102±23 to 70±28 mg/dl, p<0.0001) and 24% (29±15 to 22±13 mg/dl, p<0.01). The reduction in sd-LDL-C by atorvastatin was 5.5-fold greater in the patients with ACS and MetS than in those without MetS (p<0.001). Contrary, that in b-LDL-C was similar between the groups.
  
  
  CONCLUSIONS
  sd-LDL-C is a superior therapeutic marker of statin treatment in patients with ACS and MetS.
authors.affiliation: Department of Cardiology, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Fukushima
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirayama
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ueno
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ohmura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mokuno
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Miida
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000188:drug therapy; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000188:drug therapy; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008077:Lipoproteins, LDL