DIRECT LDL ARCHITECT

en
Direct LDL
Package insert instructions must be carefully followed. Reliability of 1E31-20
assay results cannot be guaranteed if there are any deviations from the
instructions in this package insert.
306744 / R10
Read Highlighted Changes: Revised August 2015. B1E310
INTENDED USE REAGENT HANDLING AND STORAGE (Continued)
The MULTIGENT Direct LDL assay is used for the direct, quantitative Reagent Storage
determination of low-density lipoprotein (LDL) cholesterol in human Unopened MULTIGENT Direct LDL reagents are stable until the
serum or plasma on the ARCHITECT c Systems. expiration date shown on the label when stored at 2 to 8°C. Do not
freeze.
SUMMARY AND EXPLANATION OF TEST Reagent stability is 28 days (672 hours) if the reagent is uncapped and
Plasma lipoproteins are spherical particles containing varying onboard.
amounts of cholesterol, triglycerides, phospholipids, and proteins. The
phospholipid, free cholesterol, and protein constitute the outer surface Indications of Deterioration
of the lipoprotein particle, while the inner core contains mostly esterified Instability or deterioration should be suspected if there are precipitates,
cholesterol and triglycerides. These particles serve to solubilize and visible signs of leakage, extreme turbidity, microbial growth, if calibration
transport cholesterol and trigylcerides in the bloodstream. does not meet the appropriate package insert and/or ARCHITECT
The relative proportions of protein and lipid determine the density System Operations Manual criteria, or if controls do not meet the
of these lipoproteins and provide a basis on which to begin their appropriate criteria.
classification.1 These classes are: chylomicrons, very-low-density
lipoprotein (VLDL), low-density lipoprotein (LDL), and high-density WARNINGS AND PRECAUTIONS
lipoprotein (HDL). Numerous clinical studies have shown that the Precautions for Users
different lipoprotein classes have very distinct and varied effects on •
coronary heart disease (CHD) risk.2-4 • For In Vitro Diagnostic Use.
The studies all point to LDL cholesterol as the key factor in the • Do not use reagents beyond the expiration date.
pathogenesis of atherosclerosis and CHD,2-8 while HDL cholesterol has
been observed to have a protective effect. Even within the normal range • Do not mix reagents from different kit lot numbers.
of total cholesterol concentrations, an increase in LDL cholesterol can • Protect reagents from direct sunlight.
occur with an associated increased risk for CHD.4 • Do not freeze reagents.
• CAUTION: This product requires the handling of human specimens.
PRINCIPLES OF PROCEDURE It is recommended that all human sourced materials be considered
The MULTIGENT Direct LDL assay is a homogeneous method for potentially infectious and be handled in accordance with the OSHA
directly measuring LDL levels in serum or plasma, without the need for Standard on Bloodborne Pathogens.9 Biosafety Level 210 or other
off-line pretreatment or centrifugation steps. appropriate biosafety practices11,12 should be used for materials that
The method is in a two-reagent format and depends on the properties contain or are suspected of containing infectious agents.
of a unique detergent. This detergent, , solubilizes only the non‑LDL The following warnings and precautions apply to and :
particles. The cholesterol released is consumed by cholesterol WARNING: Contains methylisothiazolones.
esterase and cholesterol oxidase in a non-color-forming reaction.
A second detergent, , solubilizes the remaining LDL particles H317 May cause an allergic skin reaction.
and a chromogenic coupler allows for color formation. The enzyme Prevention
reaction with LDL in the presence of the coupler produces color that is P261 Avoid breathing mist/vapors/spray.
proportional to the amount of LDL cholesterol present in the sample. P272 Contaminated work clothing should not be
Methodology: Measured, Liquid Selective Detergent allowed out of the workplace.
P280 Wear protective gloves/protective clothing/
REAGENTS eye protection.
Response
Reagent Kit P302+P352 IF ON SKIN: Wash with plenty of water.
1E31-20 MULTIGENT Direct LDL is supplied as a liquid, P333+P313 If skin irritation or rash occurs: Get
ready‑to‑use, two-reagent kit which contains: medical advice/attention.
2 x 53 mL P362+P364 Take off contaminated clothing and wash
2 x 20 mL it before reuse.
Estimated tests per kit: 450 Disposal
Calculation is based on the minimum reagent fill volume per kit. P501 Dispose of contents/container in
accordance with local regulations.
Reactive Ingredients Concentration • Safety Data Sheets are available at www.abbottdiagnostics.com or
MES buffer (pH 6.3) contact your local representative.
Detergent 1 < 1.0%
Cholesterol esterase (Pseudomonas sp.) < 1,500 U/L SPECIMEN COLLECTION AND HANDLING
Cholesterol oxidase (Cellulomonas sp.) < 1,500 U/L Suitable Specimens
Peroxidase (Horseradish) < 1,300 ppg U/L Serum and plasma are acceptable specimens. Patients are not required
4-aminoantipyrine < 0.01% to fast prior to blood collection.
Ascorbic acid oxidase (Curcubita sp.) < 3,000 U/L • Serum: Use serum collected by standard venipuncture techniques
Preservative into glass or plastic tubes with or without gel barriers. Ensure
MES buffer (pH 6.3) complete clot formation has taken place prior to centrifugation.
Detergent 2 < 1.0% Separate serum from red blood cells or gel as soon after collection
N, N-bis(4-sulfobutyl)-m-toluidine, disodium (DSBmT) < 1.0 mmol/L as possible (within 3 hours).13
Preservative Some specimens, especially those from patients receiving
anticoagulant or thrombolytic therapy, may take longer to complete
REAGENT HANDLING AND STORAGE their clotting processes. Fibrin clots may subsequently form in these
Reagent Handling sera and the clots could cause erroneous results.
Remove air bubbles, if present in the reagent cartridge, with a new • Plasma: Use plasma collected by standard venipuncture techniques
applicator stick. Alternatively, allow the reagent to sit at the appropriate into glass or plastic tubes. Acceptable anticoagulants are lithium
storage temperature to allow the bubbles to dissipate. To minimize heparin (with or without gel barrier), sodium heparin, and EDTA.
volume depletion, do not use a transfer pipette to remove the bubbles. Anticoagulants containing citrate should not be used. Ensure
CAUTION: Reagent bubbles may interfere with proper detection of centrifugation is adequate to remove platelets. Separate plasma
reagent level in the cartridge, causing insufficient reagent aspiration that from red blood cells or gel as soon after collection as possible
could impact results. (within 3 hours).13

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SPECIMEN COLLECTION AND HANDLING (Continued) QUALITY CONTROL
Refer to the specimen collection tube manufacturer’s instructions for Reliability of test results should be routinely monitored with quality
processing and handling requirements. control materials or serum pools that reasonably represent performance
For total sample volume requirements, refer to the ASSAY PARAMETERS on patient specimens.15
section of this package insert and Section 5 of the ARCHITECT System As appropriate, refer to your laboratory standard operating procedure(s)
Operations Manual. and/or quality assurance plan for additional quality control requirements
Specimen Storage and potential corrective actions.
• Run two levels of controls (normal and abnormal) once during each
Serum and Plasma day of assay use.
Temperature Maximum Storage • If more frequent control monitoring is required, follow the
2 to 8°C 5 days established quality control procedures for your laboratory.
-80°C 3 months • If quality control results do not meet the acceptance criteria
Samples may be frozen once. Refer to Clinical and Laboratory defined by your laboratory, patient values may be suspect. Follow
Standards Institute (CLSI) document NCCLS H18-A3 for further the established quality control procedures for your laboratory.
instructions on specimen collection, handling, and storage.14 Recalibration may be necessary.
NOTE: Stored specimens must be inspected for particulates. If present, • Review quality control results and acceptance criteria following a
mix and centrifuge the specimen to remove particulates prior to testing. change of reagent or calibrator lot.

PROCEDURE RESULTS
Materials Provided Refer to Appendix C of the ARCHITECT System Operations Manual for
information on results calculations.
1E31-20 MULTIGENT Direct LDL Reagent Kit
To convert results from mg/dL to mmol/L, multiply mg/dL by 0.02586.16
Materials Required but not Provided Representative performance data are given in the SPECIFIC
• 5P56-01 Lipid Multiconstituent Calibrator (Lipid MCC) PERFORMANCE CHARACTERISTICS section of this package insert.
NOTE: If 5P56-01 Lipid MCC is not available, use Results obtained in individual laboratories may vary.
1E31-02 MULTIGENT LDL Calibrator.
• LDL cholesterol control sera or quality control material LIMITATIONS OF THE PROCEDURE
• Saline (0.85% to 0.90% NaCl) for specimens that require dilution Refer to the SPECIMEN COLLECTION AND HANDLING and SPECIFIC
PERFORMANCE CHARACTERISTICS sections of this package insert.
Assay Procedure
For a detailed description of how to run an assay on the ARCHITECT EXPECTED VALUES
c Systems, refer to Section 5 of the ARCHITECT System Operations The following National Cholesterol Education Program (NCEP) cutpoints
Manual. for patient classification are used for the prevention and management of
Specimen Dilution Procedures coronary heart disease.13
Serum and Plasma: The following specimens should be diluted by Reference Range
following the Manual Dilution Procedure:
LDL Cholesterol (mg/dL)
• Specimens with levels of interfering substances (other than
triglyceride) higher than the upper limit stated in the Interfering < 100 Optimal
Substances section. 100 to 129 Near or above optimal
• Specimens with LDL cholesterol values exceeding 800 mg/dL 130 to 159 Borderline high
(20.69 mmol/L). 160 to 189 High
Manual Dilution Procedure ≥ 190 Very high
Manual dilutions should be performed as follows: The NCEP Adult Treatment Panel III Report recommends the
• Use saline (0.85% to 0.90% NaCl) to dilute the sample. classification shown above. Laboratories should follow recommendations
• The operator must enter the manual dilution factor in the patient for lipid ranges effective in their locale if they differ from those of the
or control order screen. The system uses this dilution factor to NCEP.
automatically correct the concentration by multiplying the result by
the entered factor. SPECIFIC PERFORMANCE CHARACTERISTICS
• If the operator does not enter the dilution factor, the result must Reportable Range
be multiplied by the appropriate dilution factor before reporting the The reportable range of the MULTIGENT Direct LDL assay is from
result. 1 to 800 mg/dL (0.03 to 20.69 mmol/L), based on limit of blank and
(Volume of Sample + Volume of Dilution Reagent) linearity studies. Linearity was evaluated using N‑geneous LDL Linearity
Manual Dilution Factor = Verifiers, part number 80-5953-00. Linearity samples recovered within
Volume of Sample
10% of the theoretical value up to 800 mg/dL.
NOTE: If a diluted sample result is flagged indicating it is less than the
linear low limit, do not report the result. Rerun using an appropriate Limit of Blank (LOB)
dilution. The LOB for MULTIGENT Direct LDL is ≤ 10 mg/dL (0.259 mmol/L). The
For detailed information on ordering dilutions, refer to Section 5 of the LOB is the mean concentration of an analyte-free sample plus 2 SD,
ARCHITECT System Operations Manual. where SD = the pooled, within-run standard deviation of the analyte-free
sample. A study performed on an ARCHITECT c System produced an
CALIBRATION LOB for MULTIGENT Direct LDL of 0.1 mg/dL (0.003 mmol/L).
Calibration is stable for approximately 28 days (672 hours) and is
required with each change in reagent lot number. Verify calibration curve
with at least two levels of controls according to the established quality
control requirements for your laboratory. If control results fall outside
acceptable ranges, recalibration may be necessary.
For a detailed description of how to calibrate an assay, refer to Section 6
of the ARCHITECT System Operations Manual.
For information on calibrator standardization, refer to the package insert
for 5P56-01 Lipid Multiconstituent Calibrator or 1E31-02
MULTIGENT LDL Calibrator.

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SPECIFIC PERFORMANCE CHARACTERISTICS BIBLIOGRAPHY
(Continued) 1. Gotto AM. Lipoprotein metabolism and the etiology of
hyperlipidemia. Hosp Pract 1988;23(Suppl 1):4.
Interfering Substances
2. Crouse JR, Parks JS, Schey HM, et al. Studies of low density
Samples with triglyceride concentrations > 1,293 mg/dL lipoprotein molecular weight in human beings with coronary artery
(14.61 mmol/L) should not be used for the determination of LDL disease. J Lipid Res 1985;26(5):566.
cholesterol.
3. Badimon JJ, Badimon L, Fuester V. Regression of atherosclerotic
Potential interference in the MULTIGENT Direct LDL assay from ascorbic lesions by high-density lipoprotein plasma fraction in the
acid, bilirubin, gamma globulins, and hemoglobin is less than 10% at cholesterol-fed rabbit. J Clin Invest 1990;85:1234–41.
the levels indicated below. A study based on guidance from NCCLS
publication EP7-P17 was performed using the MULTIGENT Direct LDL 4. Castelli WP, Doyle JT, Gordon T, et al. HDL cholesterol and other
assay on a commercially available clinical chemistry analyzer. Varying lipids in coronary heart disease. Circulation 1977;55(5):767.
amounts of potential interferents were added to serum pools with known 5. Barr DP, Russ EM, Eder HA. Protein-lipid relationships in human
quantities of cholesterol. No significant interference was detected in the plasma. Am J Med 1951;11(4):480.
MULTIGENT Direct LDL assay up to and including the concentrations 6. Gordon T, Castelli WP, Hjortland MC, et al. High density lipoprotein
stated below: as a protective factor against coronary heart disease. Am J Med
Concentration with 1977;62(5):707.
Interfering Substance 7. Wiliams P, Robinson D, Baily A. High density lipoprotein and
No Significant Interference
Ascorbic acid 50 mg/dL (2,839 µmol/L) coronary risk factor. Lancet 1979;1:72.
Bilirubin (conjugated) 20 mg/dL (342 µmol/L) 8. Kannel WB, Castelli WP, Gordon T. Cholesterol in the prediction
Bilirubin (unconjugated) 20 mg/dL (342 µmol/L) of atheriosclerotic disease: new perspectives based on the
Framingham study. Ann Intern Med 1979;90:85.
Gamma globulins 5,000 mg/dL (50 g/L)
Hemoglobin 500 mg/dL (5 g/L) 9. US Department of Labor, Occupational Safety and Health
Administration. 29 CFR Part 1910.1030. Bloodborne Pathogens.
Interferences from medications or endogenous substances may affect 10. US Department of Health and Human Services. Biosafety in
results.18 Microbiological and Biomedical Laboratories, 5th ed. Washington,
Precision DC: US Government Printing Office, December 2009.
The precision of the MULTIGENT Direct LDL assay is < 4% CV. A 11. World Health Organization. Laboratory Biosafety Manual, 3rd ed.
within-run precision study was performed using two levels of LDL Geneva: World Health Organization, 2004.
cholesterol control human serum. Each run consisted of 20 replicate 12. Clinical and Laboratory Standards Institute (CLSI). Protection
samples. of Laboratory Workers From Occupationally Acquired Infections;
In addition, a between-run precision study was performed using two Approved Guideline–Fourth Edition. CLSI Document M29-A4. Wayne,
levels of frozen pooled human serum in accordance with CLSI protocol PA: CLSI; 2014.
NCCLS EP15-P.19 13. National Cholesterol Education Program. Detection, Evaluation, and
Representative data from these studies are summarized below. Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel
Low High III). National Institutes of Health. National Heart, Lung, and Blood
Control Institute. NIH Publication No. 01-3670. May 2001.
< 130 mg/dL ≥ 160 mg/dL
N 20 20 14. Calam RR, Bessman JD, Ernst DJ, et al. Procedures for the Handling
Mean (mg/dL) 86.8 175.9 and Processing of Blood Specimens; Approved Guideline—Third
Within Run SD 0.95 2.46 Edition. (H18-A3). Wayne, PA: Clinical and Laboratory Standards
Institute, 2004.
%CV 1.1 1.4
Mean (mg/dL) 89.0 178.1 15. Westgard JO, Burnett RW, Cooper WG, et al. Statistical Quality
Control for Quantitative Measurements: Principles and Definitions;
Between Run SD 1.92 3.94
Approved Guideline (C24-A2). Wayne, PA: Clinical and Laboratory
%CV 2.2 2.2 Standards Institute, 1999.
Accuracy 16. Tietz NW, editor. Clinical Guide to Laboratory Tests. Philadelphia, PA:
The average percent bias of the MULTIGENT Direct LDL reagent on WB Saunders; 1986:256.
a commercially available clinical chemistry analyzer to the Reference 17. Powers DM, Boyd JC, Glick MR, et al. Interference Testing in Clinical
Method (ultracentrifugation and cholesterol analysis) was less than Chemistry; Proposed Guideline (EP7-P). Villanova, PA: Clinical and
or equal to the guidelines established by the National Cholesterol Laboratory Standards Institute, 1986.
Education Program (NCEP).13 Fifty-four samples, with LDL values 18. Young DS. Effects of Drugs on Clinical Laboratory Tests, 3rd ed.
ranging from 68.1 to 214.5 mg/dL, were tested in duplicate using the Washington, DC: AACC Press; 1990:3-104–3-106.
LDL reagent on a commercially available clinical chemistry analyzer and
the Reference Method. Sample means were compared by least squares 19. Carey RN, George H, Hartmann AE, et al. User Demonstration
linear regression analysis. Data from this study are summarized below. of Performance for Precision and Accuracy; Proposed Guideline
(EP15-P). Wayne, PA: Clinical and Laboratory Standards Institute,
Reference 1998.
Method LDL Method
N 54 54 TRADEMARKS
Mean (mg/dL) 122.5 125.1 The ARCHITECT c System family of instruments consists of c 4000,
Standard Deviation (mg/dL) 30.7 30.9 c 8000, and c 16000 instruments.
Regression Analysis y = 0.95x + 3.02 mg/dL AEROSET, ARCHITECT, c 4000, c 8000, c 16000, c System, and
Correlation Coefficient r = 0.96 MULTIGENT are trademarks of Abbott Laboratories in various
Method Comparison jurisdictions.
The MULTIGENT Direct LDL assay on the AEROSET System was All other trademarks are property of their respective owners.
compared to a commercially available liquid selective detergent
methodology. Samples were run in duplicate on both systems. Sample
means were compared by least squares linear regression analysis. In
a separate study, the MULTIGENT Direct LDL assay on an ARCHITECT
c System was compared to the assay on the AEROSET System. Data
from both studies are summarized below.
AEROSET vs. ARCHITECT vs.
Method Comparative Method AEROSET
N 49 57
Y-Intercept -1.60 -1.09
Correlation Coefficient 0.99 0.99
Slope 1.02 0.98
%Bias 0.6% -2.9%
Range (mg/dL) 33.0 to 182.1 68.5 to 214.0

3
 c Systems Assay Parameters
Direct LDL Serum/Plasma—Conventional and SI Units
Configure assay parameters — General Configure assay parameters — SmartWash
● General о Calibration о SmartWash о Results о Interpretation о General о Calibration ● SmartWash о Results о Interpretation
Assay: DLDL Type: Photometric Version: † Assay: DLDL
Number: 2840
COMPONENT REAGENT / ASSAY WASH Volume Replicates
Run controls for onboard reagents by: Lot
● Reaction definition о Reagent / Sample о Validity checks
Reaction mode: End up
Primary Secondary Read times
Wavelength: 548 / 660 Main: 31 – 33
Last required read: 33 Direct LDL Serum/Plasma—Conventional Units
Absorbance range: ___ – ___ Color correction: ___ – ___
Sample blank type: Self Blank: 14 – 16 Configure assay parameters — Results
о General о Calibration о SmartWash ● Results о Interpretation
Assay: DLDL Assay number: 2840
о Reaction definition ● Reagent / Sample о Validity checks Dilution default range: Result units: mg/dL
R1 R2 Low-Linearity: 1
Reagent: DLDL0 Reagent volume: 200 67 High-Linearity: 800
Diluent: Saline Water volume: ___ ___ Gender and age specific ranges:**
Diluent dispense mode: Type 0 Dispense mode: Type 0 Type 0 GENDER AGE (UNITS) NORMAL EXTREME
Diluted Default Either 0 – 130 (Y) 100 – 159
Dilution name Sample sample Diluent Water Dilution factor dilution
STANDARD : 2.0 ___ ___ ___ = 1:1.00 ●
_________ : ___ ___ ___ ___ = о
_________ : ___ ___ ___ ___ = о Configure result units
Assay: DLDL
о Reaction definition о Reagent / Sample ● Validity checks Version: †
Reaction check: None Result units: mg/dL
Decimal places: 0 (Range 0–4)
Correlation factor: 1.0000
Maximum absorbance variation: ___ Intercept: 0.0000

Configure assay parameters — Calibration

о General ● Calibration о SmartWash о Results о Interpretation Direct LDL Serum/Plasma—SI Units
Assay: DLDL Calibration method: Linear
Configure assay parameters — Results
● Calibrators о Volumes о Intervals о Validity checks о General о Calibration о SmartWash ● Results о Interpretation
Calibrator set: Calibrator level: Concentration: Assay: DLDL Assay number: 2840
LIPIDMCC* Blank: Water 0†† Dilution default range: Result units: mmol/L
Cal 1: LIPIDMCC1* ‡ Low-Linearity: 0.03
Replicates: 3 (Range 1–3) High-Linearity: 20.69
Gender and age specific ranges:**
GENDER AGE (UNITS) NORMAL EXTREME
о Calibrators ● Volumes о Intervals о Validity checks Either 0 – 130 (Y) 2.59 – 4.11
Calibrator: LIPIDMCC* Diluted
Calibrator level Sample sample Diluent Water
Blank: Water 2.0 ___ ___ ___
Cal 1: LIPIDMCC1* 2.0 ___ ___ ___ Configure result units
Assay: DLDL
о Calibrators о Volumes ● Intervals о Validity checks Version: †
Calibration intervals: Result units: mmol/L
Full interval: 672 (hours) Decimal places: 2 (Range 0–4)
Calibration type: Correlation factor: 1.0000
Adjust type: None Intercept: 0.0000

о Calibrators о Volumes о Intervals ● Validity checks

Blank absorbance range: _____ – _____
Span: Blank – Blank
Span absorbance range: _____ – _____
Expected cal factor: 0.00
Expected cal factor tolerance %: 0

† Due to differences in instrument systems and unit configurations, version numbers may vary.
* If 5P56-01 Lipid MCC is not available, use 1E31-02 MULTIGENT LDL Calibrator. The corresponding Cal Set name and Calibrator name
are “LDL” and Cal 1 is “LDL1”.
†† Displays the number of decimal places defined in the decimal places parameter field.
‡ Refer to the value on the calibrator labeling. These values are defined on the Configure calibrator set screen.
** User defined.

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Key to Symbols

Distributed in the USA by

Do not freeze

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European Community
Identifies products to be used together

Global Trade Item Number

Information needed for United States
of America only
In Vitro Diagnostic Medical Device

Batch code/Lot number

Product of Japan
Customer Service: Contact your local representative or find country-
Reagent 1 specific contact information on www.abbottdiagnostics.com.
Reagent 2

Catalog number/List number Sekisui Diagnostics P.E.I. Inc.

70 Watts Ave.
Serial number Charlottetown, Prince Edward Island
Canada C1E 2B9
Warning: May cause an allergic reaction
Sekisui Diagnostics (UK) Ltd
Liphook Way, Allington
Consult instructions for use Maidstone, Kent, ME16 0LQ,
United Kingdom
Manufacturer Tel (+44)(0)1622-607800

Sufficient for
Abbott Laboratories
Temperature limitation Abbott Park, IL 60064 USA

Use by/Expiration date August 2015