1512 - Apolipoprotein B testing for high risk cardiovascular disease risk assessment

Page last updated: 03 April 2018

Application Detail

Status

Open

Description of Medical Service

ApoB is an essential and functional component of liver- derived very-low density lipoprotein (VLDL) and its metabolic remnants, intermediate density lipoprotein (IDL), LDL, as well as lipoprotein(a) [Lp(a)]. Plasma concentrations of apoB reflect the total number of atherogenic particles present in the circulation because each of these contains one molecule of apoB. Like LDL-cholesterol, an increased plasma concentration of apoB has been shown to be a key risk factor for the development of atherosclerotic CVD.
In a series of prospective epidemiological studies, plasma apoB (a measure of the number of VLDL, IDL, LDL, and Lp(a) particles), as measured by immunoassay, has been shown to be superior to LDL-cholesterol (a measure of the mass of cholesterol within LDL, IDL and Lp(a) particles) and non-HDL-cholesterol (a measure of the mass of cholesterol within VLDL, IDL, LDL, and Lp(a) particles) as markers of cardiovascular risk.

Description of Medical Condition

Cardiovascular disease (CVD) is largely preventable and the evaluation of risk through a comprehensive clinical and diagnostic assessment of the patient allows for more effective management of modifiable risk factors. Individual risk factors such as high blood pressure and raised lipid levels are known to be associated with increased risk of CVD events.
Measurement of apolipoprotein B (apoB) may be most relevant in patients who are hypertriglyceridaemic owing to mixed hyperlipidaemia or as an isolated abnormality. This encompasses patients with metabolic syndrome, obesity, type 2 diabetes, chronic kidney disease, and familial hyperapobetalipoproteinaemia (hyperapoB). It is also helpful in diagnosing genetic hypocholesterolaemic lipid disorders, including familial hypobetalipoproteinaemia and abetalipoproteinaemia, where apoB levels are very low or absent.
ApoB together with cholesterol and triglyceride can be used to define hyperapoB, a heterogeneous condition associated with small dense LDL and a high risk of atherosclerotic CVD.

Reason for Application

New MBS item

Medical Service Type

Investigative

Previous Application Number

Not Applicable

Associated Documentation

Application Form

Application Form (Word 124 KB)
Application Form (PDF 843 KB)

Consultation Survey

Consultation Survey (Word 508 KB)
Consultation Survey (PDF 304 KB)

PICO Confirmation

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Assessment Report

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Public Summary Document

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Meetings for this Application

PASC

12-13 April 2018

ESC

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MSAC

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