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Asymmetric dimethylarginine
Pathway / Endothelial activation & erosion

Asymmetric dimethylarginine

metabolite

ADMA inhibits endothelial NO synthase, impairing vasodilation and promoting endothelial dysfunction driving erosion.

Pathway placement
Cascade stepEndothelial activation & erosion
Confidencehigh
RationaleNOS inhibitor causing endothelial dysfunction, reduced NO and vascular activation—s4 anchor mechanism.
Druggability
Not assessed (no mapped human gene target).

Type I vs non-Type I discrimination

ScoresNon-Type-I-associated
R — rupture / Type-I
—
C — non-Type-I
61
A — assay feasibility
42
E — evidence strength
95
T1DI (composite)
11
Specificity differential (R−C)-45.6
Non-Type-I axis panel
Does this marker also move in each non-Type-I setting? mag 0–3; higher means less Type-I-specific. n/a = no evidence retrieved, which is not the same as no change.
2sepsis / systemic inflammationmag 2
2anemia / acute blood lossmag 2
2hypovolemia / dehydrationmag 2
2tachyarrhythmiamag 2
2hypoxemia / respiratory failuremag 2
2hypertensive emergencymag 2
2high-demand / peri-operative stressmag 1
3sudden cardiac deathmag 1
4aPCI-related periproceduralmag 2
4bstent thrombosisn/a
4cin-stent restenosismag 2
5CABG-relatedmag 2
Coverage: 11/12 axes with evidence
Tier: deep-scored (abstract-extracted) · 27 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(7)

Clinical trials(2)