{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:10:38Z","timestamp":1791378638202,"version":"4.3.2"},"reference-count":31,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,20]],"date-time":"2022-11-20T00:00:00Z","timestamp":1668902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Several lines of evidence have supported small dense low-density lipoproteins (sd-LDL) as a marker of cardiovascular disease. The present study assessed the relationship between lipid profile and sd-LDL levels with demographic, clinical, angiographic, and therapeutic variables in acute coronary syndrome (ACS) patients. Methods: This was a single-centre, prospective, cross-sectional study conducted from September 2014 to September 2015. Patients with a diagnosis of ACS were included in this study. High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were determined by direct homogenous assay and sd-LDL levels were calculated using an earlier described equation by Srisawadi et al. Results: A total of 200 patients with a diagnosis of ACS were studied. Males constituted 78% of the population cohort and almost 45% of participants were aged &lt;45 years. Patients aged \u226445 years displayed higher mean sd-LDL levels of 30.40 \u00b1 14.18 mg\/dL versus patients aged &gt;45 years with mean sd-LDL levels of 28.01 \u00b1 11.58 mg\/dL, but the difference was not statistically significant (p = 0.19). Females also displayed higher mean sd-LDL levels, but the difference also failed to achieve statistical significance (30.95 \u00b1 13.44 mg\/dL and 28.54 \u00b1 12.64, respectively; p = 0.185). Diabetics had higher mean sd-LDL levels (33.64 \u00b1 13.01 mg\/dL and 28.07 \u00b1 12.60 mg\/dL; p = 0.273) whilst smokers had lower mean levels (27.21 \u00b1 12.12 mg\/dL and 30.51 \u00b1 13.21 mg\/dL, respectively; p = 0.071). However, the ratio of sd-LDL\/lb-LDL (large buoyant LDL) was significantly higher in diabetics (0.48 vs. 0.39; p = 0.023). In the angiography cohort (n = 88), single-vessel disease was the most predominant overall while among patients aged &gt;45 years, triple-vessel disease was significantly higher (p = 0.005). Similarly, the sd-LDL levels were 33.12 \u00b1 11.13 mg\/dL, 27.68 \u00b1 9.80 mg\/dL, and 31.65 \u00b1 15.26 mg\/dL among patients with single, double, and triple-vessel disease and did not differ significantly (p = 0.262). Prior statin users had significantly lower mean sd-LDL levels of 24.79 \u00b1 12.23 mg\/dL compared to statin-na\u00efve patients with a mean sd-LDL of 30.01 \u00b1 12.79 mg\/dL (p = 0.027). Non-HDL levels were also significantly lower in prior statin users (112.83 mg\/dL vs. 128.9 mg\/dL; p = 0.017). Conclusion: In this cohort of ACS patients, age, sex, diabetes, smoking, and the angiographic severity of coronary artery disease had no significant impact on sd-LDL levels, while prior statin usage led to significantly lower sd-LDL levels. Diabetic patients, however, did have significantly higher sd-LDL\/lb-LDL ratios.<\/jats:p>","DOI":"10.3390\/jcm11226846","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T04:33:32Z","timestamp":1669005212000},"page":"6846","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Lipid Profile and Small Dense Low-Density Lipoprotein in Acute Coronary Syndrome Patients: Relationships to Demographic, Clinical, Angiographic, and Therapeutic Variables"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2360-7580","authenticated-orcid":false,"given":"Akshyaya","family":"Pradhan","sequence":"first","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University, Lucknow 226003, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravninder","family":"Kuka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, SPS Hospital, Ludhiana 141001, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pravesh","family":"Vishwakarma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University, Lucknow 226003, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wahid","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Pathology, King George\u2019s Medical University, Lucknow 226003, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0511-2621","authenticated-orcid":false,"given":"Marco Alfonso","family":"Perrone","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardio Lab, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8421-5065","authenticated-orcid":false,"given":"Ferdinando","family":"Iellamo","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardio Lab, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Chaudhary","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University, Lucknow 226003, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharad","family":"Chandra","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University, Lucknow 226003, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Sethi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University, Lucknow 226003, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudhanshu","family":"Dwivedi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University, Lucknow 226003, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun","family":"Narain","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University, Lucknow 226003, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. K.","family":"Saran","sequence":"additional","affiliation":[{"name":"Department of Clinical & Preventive Cardiology, Medanta Hospital, Lucknow 226003, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.5551\/jat.63229","article-title":"Small dense low-density lipoprotein cholesterol and cardiovascular risk in statin-treated patients with coronary artery disease","volume":"29","author":"Ishii","year":"2022","journal-title":"J Atheroscler. Thromb."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1161\/ATVBAHA.114.303284","article-title":"Small dense low-density lipoprotein-cholesterol concentrations predict risk for coronary heart disease: The Atherosclerosis Risk in Communities (ARIC) study","volume":"34","author":"Hoogeveen","year":"2014","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e019140","DOI":"10.1161\/JAHA.120.019140","article-title":"Small dense low-density lipoprotein cholesterol is the most atherogenic lipoprotein parameter in the prospective Framingham Offspring Study","volume":"10","author":"Ikezaki","year":"2021","journal-title":"J Am Heart Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"251","DOI":"10.14740\/cr1254","article-title":"Small dense low-density lipoprotein for risk prediction of acute coronary syndrome","volume":"12","author":"Singh","year":"2021","journal-title":"Cardiol. Res."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Zhang, J., and He, L. (2021). Relationship between small dense low density lipoprotein and cardiovascular events in patients with acute coronary syndrome undergoing percutaneous coronary intervention. BMC Cardiovasc. Disord., 21.","DOI":"10.1186\/s12872-021-01979-7"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"195","DOI":"10.5551\/jat.14936","article-title":"Small dense low-density lipoproteins cholesterol can predict incident cardiovascular disease in an urban Japanese cohort: The Suita study","volume":"20","author":"Arai","year":"2013","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1016\/j.jacc.2020.03.072","article-title":"Small dense low-density lipoprotein cholesterol predicts atherosclerotic cardiovascular disease in the Copenhagen General Population Study","volume":"75","author":"Balling","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1194\/jlr.D300007-JLR200","article-title":"A novel and simple method for quantification of small, dense LDL","volume":"44","author":"Hirano","year":"2003","journal-title":"J. Lipid Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1373\/clinchem.2010.149559","article-title":"Development of a homogeneous assay for measurement of small dense LDL cholesterol","volume":"57","author":"Ito","year":"2011","journal-title":"Clin Chem."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/j.cca.2010.12.003","article-title":"Evaluation of a new homogenous method for detection of small dense LDL cholesterol: Comparison with the LDL cholesterol profile obtained by density gradient ultracentrifugation","volume":"412","author":"Albers","year":"2011","journal-title":"Clin Chim. Acta"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s12291-011-0114-6","article-title":"A simple economical method for assay of atherogenic small dense low-density lipoprotein-cholesterol (sdLDL-C)","volume":"26","author":"Renjith","year":"2011","journal-title":"Indian J. Clin Biochem."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1309\/AJCPLHJBGG9L3ILS","article-title":"Estimation of plasma small dense LDL cholesterol from classic lipid measures","volume":"136","author":"Srisawasdi","year":"2011","journal-title":"Am. J. Clin Pathol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"14","DOI":"10.3126\/ajms.v12i1.31191","article-title":"Can calculated SdLDL serve as a substitute for estimated SdLDL?","volume":"12","author":"Samanta","year":"2021","journal-title":"Asian J. Med. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1161\/CIR.0b013e31826e1058","article-title":"Joint ESC\/ACCF\/AHA\/WHF Task Force for the Universal Definition of Myocardial Infarction; Katus, H.A.; Lindahl, B.; Morrow, D.A. Third universal definition of myocardial infarction","volume":"126","author":"Thygesen","year":"2012","journal-title":"Circulation"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1093\/eurheartj\/ehv320","article-title":"2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)","volume":"37","author":"Roffi","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2008.11.029","article-title":"Echocardiographic assessment of valve stenosis: EAE\/ASE recommendations for clinical practice","volume":"22","author":"Baumgartner","year":"2009","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1093\/clinchem\/18.6.499","article-title":"Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge","volume":"18","author":"Friedewald","year":"1972","journal-title":"Clin Chem."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.mjafi.2020.09.007","article-title":"Acute coronary syndrome in young males after a prolonged stay at high altitude","volume":"77","author":"Sud","year":"2021","journal-title":"Med. J. Armed Forces India."},{"key":"ref_19","first-page":"233","article-title":"Clinical characteristics of patients less than forty years old with coronary artery disease in Taiwan: A cross-sectional study","volume":"33","author":"Tsai","year":"2017","journal-title":"Acta Cardiol. Sin."},{"key":"ref_20","first-page":"378","article-title":"Pattern of risk factors and management strategies in patients with acute coronary syndrome","volume":"31","author":"Reda","year":"2018","journal-title":"Menoufia Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1007\/s12291-016-0592-7","article-title":"The association between small dense low density lipoprotein and coronary artery disease in North Indian patients","volume":"32","author":"Goel","year":"2017","journal-title":"Indian J. Clin Biochem."},{"key":"ref_22","first-page":"8","article-title":"The association between small dense low density lipoprotein, apolipoprotein B, apolipoprotein B\/apolipoprotein A1 ratio and coronary and coronary artery stenosis","volume":"23","author":"Gohari","year":"2009","journal-title":"Med. J. Islam. Repub. Iran"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1007\/s00125-003-1111-y","article-title":"Diabetic dyslipidaemia: From basic research to clinical practice","volume":"46","author":"Taskinen","year":"2003","journal-title":"Diabetologia"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1253\/circj.70.393","article-title":"Predominance of small dense low-density lipoproteins and abnormal glucose regulation in patients with acute coronary syndrome","volume":"70","author":"Ban","year":"2006","journal-title":"Circ. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s12933-020-01015-6","article-title":"Association of small dense low-density lipoprotein with cardiovascular outcome in patients with coronary artery disease and diabetes: A prospective, observational cohort study","volume":"19","author":"Jin","year":"2020","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_26","first-page":"95","article-title":"Association of small dense LDL with coronary artery disease and diabetes in urban Asian Indians\u2014The Chennai urban rural epidemiology study (CURES-8)","volume":"53","author":"Mohan","year":"2005","journal-title":"J. Assoc. Physicians India"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.jacl.2021.09.046","article-title":"Lipid measurements in the management of cardiovascular diseases: Practical recommendations a scientific statement from the national lipid association writing group","volume":"15","author":"Wilson","year":"2021","journal-title":"J. Clin. Lipidol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.jacl.2008.06.013","article-title":"National Lipid Association Taskforce on Non-HDL Cholesterol. The importance of non-HDL cholesterol reporting in lipid management","volume":"2","author":"Blaha","year":"2008","journal-title":"J. Clin. Lipidol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1016\/S0140-6736(19)32519-X","article-title":"Application of non-HDL cholesterol for population-based cardiovascular risk stratification: Results from the Multinational Cardiovascular Risk Consortium","volume":"14","author":"Brunner","year":"2019","journal-title":"Lancet"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Kumar, S., Ali, W., Mishra, S., Pradhan, A., Sethi, R., Kushwaha, R., Singh, U.S., and Perrone, M.A. (2021). Circulating soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1): A diagnostic indicator across the spectrum of acute coronary syndrome. J. Clin Med., 10.","DOI":"10.3390\/jcm10235567"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/jch.14150","article-title":"Correlation between small and dense low-density lipoprotein cholesterol and cardiovascular events in Beijing community population","volume":"23","author":"Wang","year":"2021","journal-title":"J. Clin. Hypertens"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/22\/6846\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:22:11Z","timestamp":1760145731000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/22\/6846"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,20]]},"references-count":31,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["jcm11226846"],"URL":"https:\/\/doi.org\/10.3390\/jcm11226846","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,20]]}}}