What question did this study set out to answer?

This research examines whether small dense low-density lipoprotein provides better diagnostic accuracy for coronary artery disease compared to traditional lipid markers.

January 10, 2026Open Access

Small Dense Low-density Lipoprotein: Is it a Better Diagnostic Tool for Coronary Artery Disease than Traditional Lipid Markers?

Key Points

This research examines whether small dense low-density lipoprotein provides better diagnostic accuracy for coronary artery disease compared to traditional lipid markers.
Analyzed lipid profiles in patients with suspected coronary artery disease.

Structured PICO

Does serum sdLDL level better diagnose coronary artery disease than traditional lipid markers in adults?

Population

102 adults, including 52 newly diagnosed hemodynamically stable coronary artery disease (CAD) patients and 50 age- and sex-matched healthy volunteers from the sub-Himalayan region of West Bengal, India.

Intervention

Measurement of serum small dense low-density lipoprotein (sdLDL) levels

Comparator

Measurement of traditional lipid markers (total LDL, triglycerides)

Outcome

Difference in serum sdLDL levels between CAD patients and healthy controlssurrogate

Small dense LDL levels are significantly elevated in patients with coronary artery disease even when total LDL levels are normal, suggesting it may be a superior biomarker for ASCVD risk assessment.

Abstract

Background: Coronary artery disease (CAD) is one of the commonest causes of disability and death over the globe.Atherosclerosis is the underlying process responsible for CAD, primarily affecting medium-and large-sized arteries.Low-density lipoprotein (LDL), along with its heterogeneous spectrum of particles, plays a major role in atherosclerosis.In recent studies, small dense LDL (sdLDL) particles were found to be atherogenic as they are very much susceptible to oxidation, easily permeable to vessel endothelium, and have decreased LDL receptor affinity.The aim of this study is to check whether sdLDL is a better diagnostic tool for coronary atherosclerosis than standard lipids and lipoproteins.Aim: To find out the possible diagnostic importance of sdLDL levels in CAD patients in the sub-Himalayan region of West Bengal attending North Bengal Medical College and Hospital.Materials and methods: An institutional cross-sectional case-control study was done in the Department of Biochemistry and Department of Cardiology, North Bengal Medical College and Hospital, Darjeeling.Fifty-two diagnosed and admitted CAD patients were included in the study as "cases" and 50 age-and sex-matched healthy volunteers were included as "control" subjects.The serum level of sdLDL was measured by precipitation with the heparin-MnCl 2 method and then using a direct low-density lipoprotein-cholesterol (LDL-C) assay kit.Total serum was also measured directly from the serum by a direct LDL kit.Results: In the present study, the level of serum sdLDL was found to be significantly higher than in controls (Z = 7.116 and p-value 0.00001).The percentage of sdLDL out of total LDL level was found to be higher in CAD patients than healthy control subjects.The association of sdLDL with CAD has been found to be much stronger than that of total LDL, the lipid parameter that is traditionally measured for cardiovascular risk assessment. Conclusion:The results of the present study give a definitive and more conclusive idea about the role of serum sdLDL level measurement to predict the risk of developing atherosclerosis and CAD vs the total LDL level that is conventionally measured.

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