adenosine
metaboliteAdenosine inhibits platelet activation and thrombus formation while promoting endothelial function and myocardial cardioprotection via ticagrelor-independent mechanisms.
Pathway placement
Cascade stepPlatelet adhesion & activation
Confidencehigh
RationalePlatelet inhibitor and endothelial function mediator; anti-thrombotic and cardioprotective effects across multiple cascade steps.
Also acts inEndothelial activation/erosion, Myocardial injury
Druggability
Not assessed (no mapped human gene target).
Type I vs Type II discrimination
ScoresType-II-associated
R — rupture / Type-I—
C — confounder / Type-II67
A — assay feasibility42
E — evidence strength95
T1DI (composite)10
Specificity differential (R−C)-51.7
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationn/a
2anemia / acute blood lossn/a
3hypovolemia / dehydrationmag 2
4tachyarrhythmiamag 2
5hypoxemia / respiratory failuremag 2
6hypertensive emergencyn/a
7high-demand / peri-operative stressmag 2
Coverage: 4/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 6 supporting references. See the discrimination table for all markers.
Assay & specimen
Class-level default (no specific cleared assay)— generic method inferred from analyte class; confirm against a specific product insert before use.
Specimen
Serum, plasma or urine
Collection tube
Serum separator (gold/red-top, SST) · Lithium heparin (green-top) · Sterile urine container
Method / principle
LC-MS/MS (targeted metabolomics) or enzymatic colorimetric where available
Reagent / substrate
Stable-isotope-labeled internal standard (MS); or enzyme-coupled Trinder reagent
Platform
LC-MS/MS; some automated chemistry
Turnaround · availability
Send-out / research · Specialized / research
Literature evidence(6)
- A circular network of adenosine-mediated mitochondrial dysfunction as coregulators of acute myocardial infarction.International journal of medical sciences · 2024 · PMID 38818463 · doi
- Exploring the mechanism underlying the cardioprotective effect of shexiang baoxin pill on acute myocardial infarction rats by comprehensive metabolomics.Journal of ethnopharmacology · 2020 · PMID 32464316 · doi
- Effects of Ticagrelor, Prasugrel, or Clopidogrel on Endothelial Function and Other Vascular Biomarkers: A Randomized Crossover Study.JACC. Cardiovascular interventions · 2018 · PMID 29805112 · doi
- Rationale and design of the Hunting for the off-target propertIes of Ticagrelor on Endothelial function and other Circulating biomarkers in Humans (HI-TECH) trial.American heart journal · 2017 · PMID 28625369 · doi
- Comparison of Ticagrelor Versus Prasugrel for Inflammation, Vascular Function, and Circulating Endothelial Progenitor Cells in Diabetic Patients With Non-ST-Segment Elevation Acute Coronary Syndrome Requiring Coronary Stenting: A Prospective, Randomized, Crossover Trial.JACC. Cardiovascular interventions · 2017 · PMID 28838475 · doi
- Extracellular ATP metabolism on vascular endothelial cells: A pathway with pro-thrombotic and anti-thrombotic molecules.Vascular pharmacology · 2015 · PMID 25989108 · doi
Clinical trials(2)
- High On-treatment Platelet Reactivity to Adenosine Diphosphate Identified by Multiple Platelet Function Assay Guide to Modify Anti-platelet Strategy in Patients Undergoing Percutaneous Coronary InterventionNCT02699008 · NA · COMPLETED · Clopidogrel, Ticagrelor
- A Single Center Diagnostic, Cross-sectional Study of Coronary Microvascular DysfunctionNCT03537586 · NA · ACTIVE_NOT_RECRUITING · Bivalirudin, Adenosine, Heparin, Pressure-Temperature Sensor Guidewire