Specimen Collection

Refrigerate @ 2-8 degree within 8 hours of collection.

48 hours post collect freeze at -20 degree.

This test may be vetted by a pathologist.

The clinical information for the test must be clearly written on the request form. If clinical information is not provided, or does not provide sufficient justification for the test, the test may be declined.

Declined tests :

If a test is declined, the specimen will be held for a reasonable period (usually 3 weeks but dependant on the stability of the sample). Medical practitioners seeking approval for a declined test should email the on-call Chemical Pathologist ( chemicalpathologist@adhb.govt.nz ) , giving the patient's name and NHI number and the clinical justification for the test. If unable to email, call the on-call Chemical Pathologist via Lablink (09-3078995) and identify yourself as a doctor.

Test vetting policy

4.5 mL PST Blood (Preferred)

5 mL Heparin Blood

3.5 mL SST Blood
Reference Intervals

Units: nmol/L

Reference range: 0 - 120 Please note change of units and reference interval as of 20/1/14

Uncertainty of Measurement: 5%

Turnaround Time: Within 1 week

Performed Weekly.

Following pathologist approval.

Assay Method

Principle : Immunoturbidimetric assay

Assay : Roche Tina-quant Lipoprotein(a) Gen. 2

Analyser : Cobas c502

Diagnostic Use and Interpretation

Lipoprotein (a) is an atherogenic lipoprotein and is a modest independent risk factor for premature coronary artery disease. It is thought to have pro-thrombotic effects.

Lp(a) levels are mainly genetically determined and are not responsive to diet or to lipid-lowering drugs.

Lp(a) is pronounced "lipoprotein little A".

Lp(a) is NOT the same as apolipoprotein A1 which is the protein associated with HDL (high-density lipoprotein).

Routine measurement of lipoprotein (a) is not indicated as part of a cardiovascular risk assessment in primary care.

There are no clinical trials that have adequately tested the hypothesis that Lp(a) reduction reduces the incidence of first or recurrent cardiovascular events. Lp(a) levels are also difficult to alter. Therefore, widespread screening for elevated Lp(a) is not indicated. A high level would usually prompt a more aggressive approach to other risk factors, rather than treating the level itself. If the clinical approach is otherwise clear based on other risk factors, then measuring Lp(a) has little additional value.

Lp(a) tests may be vetted by a pathologist

Criteria for approval of Lp(a) tests

• Requests from cardiologists, endocrinologists or lipid/metabolic clinics do not require approval
• Other requests will require pathologist approval
• Repeated measurements of Lp(a) are not warranted and generally will not be approved
• www.bpac.org.nz ) Issue 33, p 10-21
  
  
  Contact Information
  

  Emails to chemicalpathologist@adhb.govt.nz will receive priority attention from the on-call chemical pathologist.

  If the query concerns a specific patient please include the NHI number in your email.

  If email is not a suitable option, please contact the on-call chemical pathologist via Lablink (Auckland City Hospital ext. 22000 or 09-3078995).

  Individual chemical pathologists may be contacted but will not be available at all times.

  After-hours : contact Lablink (Auckland City Hospital ext. 22000 or 09-3078995) or hospital operator for on duty staff after hours.

  
  

  Dr Samarina Musaad (Clinical Lead) : SamarinaM@adhb.govt.nz ext. 22402

  Dr Cam Kyle: CampbellK@adhb.govt.nz ext 22052

  Dr Weldon Chiu: WeldonC@adhb.govt.nz ext. 23427

  Dr Campbell Heron: CHeron@adhb.govt.nz ext. 23427

  Dr Sakunthala Jayasinghe: Sakunthala@adhb.govt.nz ext. 23427

  
  

  
  Specimen Transport Instructions for Referring Laboratories
  

  Aliquot Instructions	Minimum 0.5 mL Plasma or Serum. Preferably >0.5 mL Plasma or Serum. No hemolysis! Freeze.
  Aliquot Transport to labplus	Frozen

  Freeze sample at -20 degree before sending.
  
  

Last updated at 15:26:00 06/01/2025