Type I vs non-Type I MI discrimination

Every molecule scored on five evidence-anchored axes and a composite Type-I Discrimination Index (T1DI). The comparator is the full Fourth Universal Definition non-Type-1 set — Type 2 (supply–demand mismatch), Type 3 (sudden cardiac death), Type 4a (PCI-related), Type 4b (stent thrombosis), Type 4c (in-stent restenosis) and Type 5 (CABG-related) — so a marker scores well only if it tracks atherothrombosis and not the other ways myocardium infarcts. All non-null scores trace to PubMed references; absence of evidence is shown as —, never as zero. Sort by any column. Click a row for the molecule's full evidence page.

Evidence is abstract-level. Scores are mined from PubMed abstracts, so a cited study may be topically relevant to a marker without directly testing the Type-1-vs-non-Type-1 comparison stated. Coverage is also uneven across the comparator: the demand-mismatch (Type 2) and procedural (Type 4a/5) axes are far better studied than sudden death (Type 3) or restenosis (Type 4c). Treat this as a hypothesis-generating map, not adjudicated diagnostic evidence.

The headline result of the broadened comparator: no molecule in this catalog is Type-I-specific. Against Type 2 alone, one marker cleared the bar. Against the full non-Type-I set, zero do — the lowest non-Type-I responsiveness among markers with a real rupture signal is C = 33, well above the specificity threshold. The markers that rank highest by composite (troponin T, CK-MB, troponin I) do so on evidence strength and assay feasibility while remaining Shared — they rise after PCI and CABG too. Read this page as a map of how far the field is from a rule-in marker, not as a shortlist of ones that work.

1,948

molecules scored

325

deep-scored (Tier 1)

full abstract extraction

117

with rupture (R) evidence

299

with non-T1 (C) evidence

direct T1-vs-non-T1 studies

head-to-head

The 16 markers with direct head-to-head evidence

The strongest tier — studies that directly compare the marker between Type-I MI patients and a non-Type-I comparator group. Green = higher in Type I; orange = higher in the non-Type-I group.

Cardiac troponin I↑ Type I

hs-cTnI: T2MI 23 (10-83) ng/L vs T1MI 115 (28-576) ng/L; P<.001 (PMID 33881449)

T1DI 60.7 · 22 refs · Shared / rises in both

CK-MB↑ Type I

CK-MB mean RULN 9 (Type 1 MI) vs 4 (Type 2 MI), P=0.002; also higher % rise in T1MI vs T2MI

T1DI 62.4 · 28 refs · Shared / rises in both

Cardiac Myosin-Binding Protein C↑ Type I

cMyBP-C at presentation: T1MI 257 (75-876) ng/L vs T2MI 76 (38-189) ng/L; P<.001

T1DI 28.3 · 2 refs · Shared / rises in both

Troponin T↑ Type I

T2MI hs-cTnT 30 (17-55) ng/L vs T1MI 58 (28-150) ng/L, P<.001 (Nestelberger 2021); RULN 207 (T1) vs 86 (T2), P=0.02 (32234496)

T1DI 65.9 · 25 refs · Shared / rises in both

Cholesterol↑ Type I

High cholesterol associated with T1MI vs T2MI incidence (OR 1.01, 95% CI 1.00-1.02, P=0.008)

T1DI 37.4 · 7 refs · Indeterminate

Free fatty acid (15:1)↑ Type I

Free fatty acid (15:1) candidate biomarker distinguishing T2MI from T1MI, AUC ≥ 0.85; no individual group values reported.

T1DI — · 18 refs · Insufficient evidence

miR-1↑ non-Type I

"miR-1 and miR-133a were correlated with cardiac necrosis protein markers and did not offer better discrimination" between T1MI and T2MI

T1DI 2 · 14 refs · Non-Type-I-associated

B-type natriuretic peptide↑ non-Type I

NT-proBNP: 10,327 +/- 12,923 ng/L in T2-MI vs 4675 +/- 11,740 ng/L in T1-MI (P=0.006); a second cohort found no T1/T2 discrimination

T1DI 32.6 · 18 refs · Shared / rises in both

D-dimer↑ non-Type I

Low D-dimer associated with T1MI incidence vs T2MI (OR 0.87, 95% CI 0.77-0.98, P=0.027), i.e. D-dimer higher in T2MI

T1DI 12 · 28 refs · Non-Type-I-associated

Procalcitonin↑ non-Type I

T2MI had higher baseline procalcitonin than T1MI (direction reported; magnitude/p-value not given in abstract)

T1DI 9.5 · 21 refs · Non-Type-I-associated

natriuretic peptides↑ non-Type I

NT-proBNP: 10,327 +/- 12,923 ng/L in T2-MI vs 4675 +/- 11,740 ng/L in T1-MI (P=0.006); a second cohort found no T1/T2 discrimination

T1DI 3.6 · 6 refs · Non-Type-I-associated

Apolipoprotein E↑ non-Type I

APOE levels measured in type-2 AMI patients; comparative analysis of STEMI, NSTEMI, and type-2 AMI groups performed

T1DI 7.7 · 5 refs · Non-Type-I-associated

Cystatin C↑ non-Type I

Type 1 MI: 1.07 mg/L vs Type 2 MI: 1.24 mg/L (significantly higher in T2, p<0.05 after adjustment)

T1DI 16 · 21 refs · Shared / rises in both

Copeptin↑ non-Type I

Copeptin 21.4 pmol/L in T2MI/injury vs 8.1 pmol/L in T1MI (P=0.001); confirmed in external validation cohort (n=1390)

T1DI 13.4 · 18 refs · Shared / rises in both

Growth differentiation factor 15↑ non-Type I

GDF-15: T2MI 2.26 (1.44-4.35) ng/L vs T1MI 1.56 (1.02-2.19) ng/L; P<.001

T1DI 31.5 · 24 refs · Shared / rises in both

Midregional Pro-Adrenomedullin↑ non-Type I

T2MI 0.97 (0.67-1.51) pmol/L vs T1MI 0.72 (0.53-0.99) pmol/L; P<.001

T1DI 5.8 · 6 refs · Non-Type-I-associated

All molecules — sortable scores

Direct T1-vs-non-T1 evidence only325 rows

Marker	Class	R	C	D	spec	A	E	T1DI ▼	PMIDs
Troponin TTNNT2	Shared / rises in both	100	63	+2	61.5	96	85	65.9	25
CK-MBCKM	Shared / rises in both	67	61	+2	30.1	96	100	62.4	28
Cardiac troponin ITNNI3	Shared / rises in both	100	62	+2	62.1	96	78	60.7	22
Lactate	Shared / rises in both	67	53	—	13.4	96	86	46.8	22
LDL cholesterol	Indeterminate	67	48	—	18.6	84	82	40.8	12
PCSK9PCSK9	Shared / rises in both	67	50	—	16.7	72	95	39.9	10
Cholesterol	Indeterminate	—	33	+1	-6.3	84	95	37.4	7
Oxidized LDL	Shared / rises in both	67	61	—	5.6	82	86	37.2	15
von Willebrand factorVWF	Shared / rises in both	67	64	—	3.1	72	95	35.3	26
Neutrophil gelatinase-associated lipocalin (NGAL)LCN2	Shared / rises in both	100	59	—	40.7	68	73	34.9	32
Transforming Growth Factor-BetaTGFB1	Indeterminate	67	43	—	23.8	72	75	33.4	14
B-type natriuretic peptideNPPB	Shared / rises in both	67	53	-1	1.4	96	67	32.6	18
Ischemia-modified albuminALB	Shared / rises in both	67	50	—	16.7	84	65	31.9	24
Apolipoprotein A-IAPOA1	Indeterminate	67	44	—	22.3	84	62	31.9	10
Growth differentiation factor 15GDF15	Shared / rises in both	100	73	-2	2.7	84	73	31.5	24
Endothelin-1EDN1	Shared / rises in both	67	67	—	0.0	66	95	31.4	21
Immunoglobulin G	Shared / rises in both	67	60	—	6.7	68	86	31.2	8
Matrix Metalloproteinase-2MMP2	Shared / rises in both	67	52	—	14.3	72	75	30.9	20
HDL	Indeterminate	67	33	—	33.4	84	55	30.8	5
Hemoglobin	Shared / rises in both	67	61	—	5.6	84	67	29.7	19
ADAMTS13ADAMTS13	Indeterminate	67	48	—	19.1	72	69	29.7	11
ST2IL1RL1	Shared / rises in both	67	62	—	4.8	84	66	28.9	10
Cardiac Myosin-Binding Protein CMYBPC3	Shared / rises in both	67	67	+2	24.3	68	67	28.3	2
Peroxisome proliferator-activated receptor	Shared / rises in both	67	63	—	3.7	68	80	28.2	25
P-selectinSELP	Shared / rises in both	67	63	—	3.7	72	75	28.0	26
Toll-Like Receptor 4TLR4	Shared / rises in both	67	67	—	0.0	72	78	27.9	20
FOXP3FOXP3	Indeterminate	67	43	—	23.8	52	86	27.7	13
ChymaseCMA1	Shared / rises in both	100	57	—	42.9	72	53	27.3	11
SRC tyrosine kinaseSRC	Shared / rises in both	100	60	—	40.0	72	54	27.2	6
C-X-C Chemokine Receptor Type 4CXCR4	Indeterminate	67	46	—	20.9	52	86	27.0	19
High-mobility group box 1HMGB1	Shared / rises in both	67	67	—	0.0	72	75	27.0	24
FibronectinFN1	Shared / rises in both	67	67	—	0.0	72	75	27.0	19
Prothrombin fragment 1+2F2	Shared / rises in both	67	60	—	6.7	84	60	26.9	18
Glutathione peroxidaseGPX1	Shared / rises in both	67	61	—	5.6	68	75	26.9	25
ERK1/2	Shared / rises in both	67	61	—	5.6	68	75	26.9	26
Kidney injury molecule-1HAVCR1	Shared / rises in both	67	61	—	5.6	68	75	26.9	24
Matrix metalloproteinase-9MMP9	Shared / rises in both	67	70	—	-2.7	72	75	26.3	31
Platelet-derived growth factor	Shared / rises in both	67	58	—	8.7	68	71	26.2	22
Albumin	Indeterminate	67	48	—	19.1	84	52	26.0	13
Apolipoprotein BAPOB	Shared / rises in both	67	67	—	0.0	84	60	25.2	17
FerritinFTH1	Non-Type-I-associated	—	53	—	-38.3	84	95	24.6	15
Plasminogen activator inhibitor-1SERPINE1	Shared / rises in both	67	52	—	14.8	72	58	24.0	16
HDL cholesterol	Indeterminate	33	33	—	-0.3	84	57	23.9	6
antithrombin IIISERPINC1	Non-Type-I-associated	—	50	—	-35.0	84	86	23.5	17
Methylglyoxal	Shared / rises in both	100	67	—	33.3	42	84	23.4	10
ATPase Sarcoplasmic/Endoplasmic Reticulum Calcium ATPase 2ATP2A2	Shared / rises in both	67	62	—	4.8	52	86	23.4	13
Interleukin-2IL2	Indeterminate	67	48	—	18.9	68	58	23.4	20
Interferon-GammaIFNG	Indeterminate	33	47	—	-13.4	72	75	23.4	18
Interleukin-10IL10	Indeterminate	—	41	—	-25.7	72	86	23.0	15
E-selectinSELE	Shared / rises in both	67	58	—	9.4	72	58	22.8	24
Basic Fibroblast Growth FactorFGF2	Shared / rises in both	67	67	—	0.0	72	62	22.4	8
Very-Low-Density Lipoprotein	Shared / rises in both	67	50	—	17.0	82	46	22.1	4
IL-6 ReceptorIL6R	Shared / rises in both	67	60	—	7.0	84	49	22.0	11
LPC (18:2)	Indeterminate	—	0	—	15.0	40	95	21.9	1
Glutathione peroxidase 4GPX4	Shared / rises in both	67	60	—	7.0	68	60	21.8	21
Insulin-like Growth Factor-1IGF1	Non-Type-I-associated	—	52	—	-36.5	72	95	21.7	17
Endothelial nitric oxide synthaseNOS3	Non-Type-I-associated	—	52	—	-36.9	72	95	21.6	13
Thrombopoietin ReceptorMPL	Shared / rises in both	67	67	—	0.0	72	59	21.1	1
Phosphatidylinositol 3-kinase	Shared / rises in both	67	58	—	8.4	52	75	21.1	22
Interleukin-6IL6	Shared / rises in both	67	61	—	6.1	72	55	21.0	23