**Author details**

The RDW is a measurement of cell size distribution and is commonly requested test used for variety of purposes, for instance to distinguish aneamias [51]. Recent work has revealed a strong correlation between elevated RDW and the occurrence of fatal and nonfatal cardiovascular events [52]. Complete blood count risk score including RDW was strongly associated with all-cause mortality in the JUPITER study in primary populations initially free from cardiovascular disease [53]. Recently, Lippi et al. [23] reported a significant association of increased RDW and low HDL-C, as well as relation with high TG and high AIP involving 4874 unselected outpatients. An interventional study of 79 patients treated with atorvastatin (10– 80 mg) for 24-week period has not shown significant RDW changes [21]. It remains still unknown which physiological process leads to previous outcomes, although inflammation has been reported as possible cause [54]. Therefore, there might be a new and unpredictable

It has been suggested that cardiovascular risk may be more closely related to atherogenic lipoprotein profile mostly represented by presence of sdLDL-C particles [55]. To our knowledge, the present study was the first to analyse MPV and RDW in relation to concentration of lipoprotein subfractions, especially with sdLDL-C. The main finding was that MPV and RDW correlated with sdLDL-C and in subgroup of sdLDL-C lowering effect after treatment, indeed, there was significant decrease in MPV value (**Table 6**). This may indicate that subjects with more a pronounced lipid-lowering effect after statin treatment may benefit also from effects beyond this well-known action. We have also observed that platelet count and haemoglobin value have changed significantly after statin therapy in this subgroup. However, this finding

The current study results suggest that MPV and RDW can play an important role not only in hypercholesterolaemia but also interfering with atherogenic small dense lipoproteins. Haematological parameters can be easily analysed at low cost and indices be new biomarkers for atherosclerosis. The potential problems that may concern is that various studies revealed the significance of MPV or RDW about the presence of various diseases and confounding factors (obesity, smoking, arterial hypertension, inflammation diseases, pulmonary embolism, etc.). Its clinical significance, however, remains largely difficult. There is still a need for further

This work was supported by a grant from the European Regional Development Fund—Project FNUSA-ICRC (No. CZ.1.05/1.1.00/02.0123). We would like to acknowledge the excellent technical assistance of all participants from 2nd Department of Internal Medicine, Faculty of

The authors declare no conflict of interest and have not received any funding or benefits from

prospective, multicentre studies with a large sample size to fully clarify the issue.

Medicine, Comenius University, Bratislava, Slovak Republic.

industry or any for profit organization for this work.

**Conflict of interest and funding**

scenario in the clinical usefulness of RDW.

52 Cholesterol Lowering Therapies and Drugs

appears not to be clinically important.

**Acknowledgements**

Marek Kucera\* , Stanislav Oravec and Ludovit Gaspar

\*Address all correspondence to: marekucera@gmail.com

2nd Department of Internal Medicine, Comenius University in Bratislava, Slovak Republic
