Dyslipidemia is a potent risk factor for the genesis and progression of
cardiovascular disease (CVD), and both the concentration and type of
low-density lipoproteins (
LDL) augment this association. The small, dense
LDL (sdLDL) subfraction is the subtype which is most strongly predictive of
atherosclerosis and cardiovascular events. In addition to the traditionally available
lipid-lowering treatment options, certain novel
therapies have been shown to favorably impact sdLDL, among them the
antidiabetic class of agents known as
glucagon-like peptide 1 receptor agonists (GLP1-RAs). These drugs seem to alter the pathophysiologic mechanisms responsible for the formation and accumulation of atherogenic
lipoprotein particles, thus potentially reducing cardiovascular outcomes. They represent a uniquely targeted therapeutic approach to reduce cardiometabolic risk and warrant further study for their beneficial nonglycemic actions.