Small, dense low-density lipoprotein subclass pattern B: issues for the clinician.

A large portion of coronary artery disease (CAD) can be attributed to disorders of lipoprotein metabolism. However, these disorders are a complex interaction of genetic susceptibility and environmental interaction. The most common disorder of lipoprotein metabolism contributing to CAD is the Small, Dense Low-Density Lipoprotein Pattern B disorder, also known as the Atherogenic Lipoprotein Profile (ALP), which consists of multiple metabolic disorders. This disorder is an independent risk factor for CAD and in patients with established CAD, identifies a subgroup with a twofold greater rate of arteriographic progression compared with CAD patients without this disorder. Treatment of the disorder is specific to lifestyle and some pharmacologic agents. The most effective treatments are often the least expensive.