Small dense LDL cholesterol associated with severe coronary artery disease
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The aim of this study was to determine whether small dense low-density lipoprotein cholesterol (sd-LDL-C) was superior to LDL-C as a biomarker for coronary heart disease (CHD). To this end, LDL particle size was determined by gradient gel electrophoresis and sd-LDL-C was quantified by heparin-magnesium precipitation in 482 stable CHD patients and 389 control subjects without diabetes and CHD. Compared to controls, CHD patients had significantly smaller LDL particles and lower large-LDL-C concentrations along with significantly higher sd-LDL-C concentrations. Irrespective of treatment by LDL-lowering drugs and history of myocardial infarction and/or coronary revascularization, LDL-C levels were modestly higher and sd-LDL-C levels were significantly higher in a subgroup of 258 patients with angiographically-documented severe CHD than in patients with mild CHD. In contrast, large-LDL-C concentrations were similar in both groups. Independently of LDL-C, sd-LDL-C concentrations were significantly associated with severe CHD. In conclusion, the association between sd-LDL-C and severe CHD appears superior to that of LDL-C.
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