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Cholesterol
Pathway / Lipid retention & oxidation

Cholesterol

metabolite

Cholesterol and atherogenic lipoprotein-associated cholesterol drive intimal retention, foam cell formation, inflammasome activation, and plaque destabilization.

Pathway placement
Cascade stepLipid retention & oxidation
Confidencehigh
RationaleCentral lipid substrate; ApoB-lipoprotein retention; oxidative modification; foam cell lipidome; plaque crystalline inflammation.
Also acts inVascular inflammation, Platelet activation
Druggability
Not assessed (no mapped human gene target).

Type I vs non-Type I discrimination

ScoresIndeterminate
R — rupture / Type-I
—
C — non-Type-I
33
A — assay feasibility
84
E — evidence strength
95
T1DI (composite)
37
Specificity differential (R−C)-6.3
Direct evidence: higher in Type I (D=+1)
High cholesterol associated with T1MI vs T2MI incidence (OR 1.01, 95% CI 1.00-1.02, P=0.008)
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 inflammationn/a
2anemia / acute blood lossn/a
2hypovolemia / dehydrationn/a
2tachyarrhythmiamag 0
2hypoxemia / respiratory failuremag 2
2hypertensive emergencyn/a
2high-demand / peri-operative stressmag 1
3sudden cardiac deathmag 1
4aPCI-related periproceduraln/a
4bstent thrombosisn/a
4cin-stent restenosismag 1
5CABG-relatedn/a
Coverage: 5/12 axes with evidence
Tier: deep-scored (abstract-extracted) · 7 supporting references. See the discrimination table for all markers.

Assay & specimen

Validated clinical assay
Specimen
Serum or plasma
Collection tube
Serum separator (gold/red-top, SST) · Lithium heparin (green-top)
Method / principle
Enzymatic (CHOD-PAP)
Reagent / substrate
Cholesterol esterase + cholesterol oxidase + peroxidase, Trinder chromogen
Platform
Automated chemistry analyzer
Turnaround · availability
Routine · Universal

Literature evidence(7)