ABSTRACT
Low-density lipoprotein cholesterol (LDL-C) is generally considered to be pro-atherogenic and high-density lipoprotein cholesterol (HDL-C) to be anti-atherogenic. The clinical approach to the diagnostics and treatment of clinical manifestations of atherosclerosis is the examination of the lipid spectrum. In routine clinical practice, the effects of the HDL class are measured only by determining the concentration of HDL cholesterol. It is questionable whether this clinical approach provides sufficient information to evaluate both the overall cardiovascular risk and the effect of hypolipidemic therapy. Recent studies revealed a shift from large to small HDL particles within the HDL family in the state of atherosclerotic cardiovascular diseases (CVD). This trend of lipoprotein constellation seems to be pathognomonic for dysfunctional lipoprotein profile under pathological state of the cardiovascular system. Thus, the diagnostic and therapeutic approach based on "good" cholesterol concept needs remedying (Fig. 1, Ref. 28).
