Choline

metabolite

Dietary and metabolic marker associated with lipid retention, plaque inflammation, and thrombotic MI risk.

Pathway placement

Cascade stepLipid retention & oxidation

Confidencemedium

RationaleDietary metabolite linked to plaque destabilization, thrombosis, and ACS; lipid metabolism marker.

Also acts inVascular inflammation, Coagulation / thrombus

Druggability

Not assessed (no mapped human gene target).

Type I vs non-Type I discrimination

ScoresIndeterminate

R — rupture / Type-I

—

C — non-Type-I

A — assay feasibility

E — evidence strength

T1DI (composite)

Specificity differential (R−C)-26.7

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 1

2anemia / acute blood lossn/a

2hypovolemia / dehydrationn/a

2tachyarrhythmian/a

2hypoxemia / respiratory failuren/a

2hypertensive emergencyn/a

2high-demand / peri-operative stressn/a

3sudden cardiac deathmag 2

4aPCI-related periproceduralmag 1

4bstent thrombosisn/a

4cin-stent restenosismag 1

5CABG-relatedn/a

Coverage: 4/12 axes with evidence

Tier: deep-scored (abstract-extracted) · 5 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(4)

Plasma metabolomic profiling of patients with acute coronary syndrome treated with potent platelet inhibitors.
Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2026 · PMID 41564597 · doi
Circulating metabolites from the choline pathway and acute coronary syndromes in a Chinese case-control study.
Nutrition & metabolism · 2020 · PMID 32489394 · doi
Choline in acute coronary syndrome: an emerging biomarker with implications for the integrated assessment of plaque vulnerability.
Expert review of molecular diagnostics · 2010 · PMID 20214535 · doi
Choline in whole blood and plasma: sample preparation and stability.
Clinical chemistry · 2008 · PMID 18310145 · doi

Clinical trials(1)

Evaluation of the Role of Eggs on Antioxidant Status, Plasma Choline and Lipoprotein Metabolism in Adults With Metabolic Syndrome Consuming a Plant-based Diet
NCT04234334 · NA · COMPLETED · Consume 2 eggs with spinach per day, Egg Subsitute with spinach per day