Some
lipoprotein disorders related to the residual risk of premature
cardiovascular disease (PCVD) are not detected by the conventional
lipid profile. In this case-control study, the predictive power of PCVD of serum sdLDL-C, measured using a
lipoprotein precipitation method, and of the physicochemical properties of serum
lipoproteins, analyzed by nuclear magnetic resonance (NMR) techniques, were evaluated. We studied a group of patients with a first PCVD event (n = 125) and a group of control subjects (n = 190). Conventional
lipid profile, the size and number of
Very Low Density Lipoproteins (VLDL),
Low Density Lipoproteins (
LDL),
High Density Lipoproteins (HDL) particles, and the number of particles of their subclasses (large, medium, and small) were measured. Compared to controls, PCVD patients had lower concentrations of all
LDL particles, and smaller and larger diameter of
LDL and HDL particles, respectively. PCVD patients also showed higher concentrations of small dense
LDL-cholesterol (sdLDL), and
triglycerides (Tg) in
LDL and HDL particles (HDL-Tg), and higher concentrations of large VLDL particles. Multivariate logistic regression showed that sdLDL-C, HDL-Tg, and large concentrations of
LDL particles were the most powerful predictors of PCVD. A strong relationship was observed between increased HDL-Tg concentrations and PCVD. This study demonstrates that beyond the conventional
lipid profile, PCVD patients have other atherogenic
lipoprotein alterations that are detected by magnetic resonance imaging (MRI) analysis.