CoronaryAtlas logo
CoronaryAtlas
homocysteine
Pathway / Endothelial activation & erosion

homocysteine

metabolite

Elevated homocysteine impairs endothelial function and promotes oxidative modification of LDL, accelerating atherosclerotic lipid retention and plaque vulnerability.

Pathway placement
Cascade stepEndothelial activation & erosion
Confidencemedium
RationaleEndothelial dysfunction marker; homocysteinylated LDL enhances atherogenic lipid accumulation.
Also acts inLipid entry/oxidation, Platelet activation, Systemic / off-pathway, Vascular inflammation
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
53
A — assay feasibility
84
E — evidence strength
61
T1DI (composite)
16
Specificity differential (R−C)-38.3
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 inflammationmag 2
2anemia / acute blood lossmag 2
2hypovolemia / dehydrationmag 1
2tachyarrhythmiamag 2
2hypoxemia / respiratory failuren/a
2hypertensive emergencymag 2
2high-demand / peri-operative stressmag 2
3sudden cardiac deathmag 1
4aPCI-related periproceduraln/a
4bstent thrombosismag 1
4cin-stent restenosismag 1
5CABG-relatedmag 2
Coverage: 10/12 axes with evidence
Tier: deep-scored (abstract-extracted) · 27 supporting references. See the discrimination table for all markers.

Assay & specimen

Validated clinical assay
Specimen
Plasma (EDTA, chilled, separate promptly) or serum
Collection tube
K2-EDTA, chilled plastic (lavender-top) · Serum separator (gold/red-top, SST)
Method / principle
Immunoassay (enzymatic conversion) or LC-MS/MS
Reagent / substrate
SAH hydrolase-coupled enzymatic cycling; or isotope-labeled IS for MS
Platform
Automated analyzer / LC-MS/MS
Turnaround · availability
Routine–send-out · Widely available

Literature evidence(17)