Pathway / Off-pathway / systemic markers

Cyclic GMP

metabolite

Cyclic GMP serves as a vascular signaling molecule whose levels correlate with atherosclerotic plaque burden.

Pathway placement

Cascade stepOff-pathway / systemic markers

Confidencelow

RationaleSecond messenger; plaque-burden correlation suggests vascular but not specific atherothrombotic 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

A — assay feasibility

E — evidence strength

T1DI (composite)

Specificity differential (R−C)-43.3

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 / dehydrationmag 2

2tachyarrhythmiamag 2

2hypoxemia / respiratory failuren/a

2hypertensive emergencyn/a

2high-demand / peri-operative stressn/a

3sudden cardiac deathmag 1

4aPCI-related periproceduraln/a

4bstent thrombosisn/a

4cin-stent restenosisn/a

5CABG-relatedmag 2

Coverage: 4/12 axes 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(1)

Multinomial machine learning identifies independent biomarkers by integrated metabolic analysis of acute coronary syndrome.
Scientific reports · 2023 · PMID 37996510 · doi