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Cortisol
Pathway / Off-pathway / systemic markers

Cortisol

metabolite

Cortisol elevation during acute MI reflects systemic stress response via HPA-axis independent of atherothrombotic cascade.

Pathway placement
Cascade stepOff-pathway / systemic markers
Confidencemedium
RationaleSystemic neuroendocrine/HPA-axis stress response; off atherothrombotic cascade.
Druggability
Not assessed (no mapped human gene target).

Type I vs non-Type I discrimination

ScoresNon-Type-I-associated
R — rupture / Type-I
33
C — non-Type-I
54
A — assay feasibility
84
E — evidence strength
61
T1DI (composite)
20
Specificity differential (R−C)-21.2
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 lossn/a
2hypovolemia / dehydrationn/a
2tachyarrhythmiamag 1
2hypoxemia / respiratory failuremag 2
2hypertensive emergencyn/a
2high-demand / peri-operative stressmag 2
3sudden cardiac deathmag 2
4aPCI-related periproceduralmag 2
4bstent thrombosisn/a
4cin-stent restenosismag 0
5CABG-relatedmag 2
Coverage: 8/12 axes with evidence
Tier: deep-scored (abstract-extracted) · 15 supporting references. See the discrimination table for all markers.

Assay & specimen

Validated clinical assay
Specimen
Serum/plasma (timed); saliva; 24h urine (free)
Collection tube
Serum separator (gold/red-top, SST) · Sterile urine container
Method / principle
Chemiluminescent immunoassay or LC-MS/MS
Reagent / substrate
Anti-cortisol antibody; or deuterated cortisol IS for MS
Platform
Automated analyzer / LC-MS/MS
Turnaround · availability
Routine · Universal

Literature evidence(2)

Clinical trials(1)