Pathway / Myocardial injury (shared endpoint)

Free fatty acid (15:1)

lipid

Free fatty acid (15:1) elevation discriminates atherothrombotic MI from Type 2 MI, marking ischemic lipid catabolism.

Pathway placement

Cascade stepMyocardial injury (shared endpoint)

Confidencemedium

RationaleType 1 MI discriminator; reflects lipid mobilization and myocardial metabolic crisis.

Also acts inLipid entry/oxidation

Druggability

Not assessed (no mapped human gene target).

Type I vs non-Type I discrimination

ScoresInsufficient evidence

R — rupture / Type-I

—

C — non-Type-I

—

A — assay feasibility

E — evidence strength

T1DI (composite)

—

Specificity differential (R−C)—

Direct evidence: higher in Type I (D=+1)

Free fatty acid (15:1) candidate biomarker distinguishing T2MI from T1MI, AUC ≥ 0.85; no individual group values reported.

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

2tachyarrhythmian/a

2hypoxemia / respiratory failuren/a

2hypertensive emergencyn/a

2high-demand / peri-operative stressn/a

3sudden cardiac deathn/a

4aPCI-related periproceduraln/a

4bstent thrombosisn/a

4cin-stent restenosisn/a

5CABG-relatedn/a

Coverage: 0/12 axes with evidence

Tier: deep-scored (abstract-extracted) · 18 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 or plasma (EDTA to limit oxidation)

Collection tube

K2/K3-EDTA (lavender-top) · Serum separator (gold/red-top, SST)

Method / principle

LC-MS/MS lipidomics (targeted or shotgun)

Reagent / substrate

Deuterated lipid-class internal standards; MS/MS transitions

Platform

LC-MS/MS

Turnaround · availability

Research · Research-only

Literature evidence(1)

Pseudo-targeted metabolic profile differences between emergency patients with type 1 and type 2 myocardial infarction diagnosed by optical coherence tomography.
Clinica chimica acta; international journal of clinical chemistry · 2024 · PMID 38185283 · doi