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L-arginine
Pathway / Endothelial activation & erosion

L-arginine

metabolite

L-arginine availability limits nitric oxide production, and its depletion associates with endothelial dysfunction and ACS severity.

Pathway placement
Cascade stepEndothelial activation & erosion
Confidencemedium
RationaleNOS substrate required for NO synthesis; low levels reflect endothelial dysfunction.
Druggability
Not assessed (no mapped human gene target).

Type I vs non-Type I discrimination

ScoresIndeterminate
R — rupture / Type-I
—
C — non-Type-I
42
A — assay feasibility
42
E — evidence strength
18
T1DI (composite)
3
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 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 deathmag 2
4aPCI-related periproceduralmag 1
4bstent thrombosisn/a
4cin-stent restenosismag 1
5CABG-relatedmag 1
Coverage: 4/12 axes with evidence
Tier: deep-scored (abstract-extracted) · 7 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(2)