L-lactic acid
metaboliteL-lactic acid dysregulation reflects myocardial ischemia, hypoxia, and metabolic demand–supply mismatch in acute coronary syndrome.
Pathway placement
Cascade stepOff-pathway / systemic markers
Confidencehigh
RationaleLactate reflects tissue hypoxia and cardiomyocyte ischemic stress; downregulation may indicate metabolic recovery.
Also acts inMyocardial injury
Druggability
Not assessed (no mapped human gene target).
Type I vs Type II discrimination
ScoresLow-confidence (proxy)
R — rupture / Type-I62
C — confounder / Type-II53
A — assay feasibility42
E — evidence strength25
T1DI (composite)6
Specificity differential (R−C)+9.3
Confounder panel (Type-II drivers)
No confounder evidence retrieved.
Tier: light (literature co-occurrence proxy — lower confidence). 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)
- Urinary metabonomic study of patients with acute coronary syndrome using UPLC-QTOF/MS.Journal of chromatography. B, Analytical technologies in the biomedical and life sciences · 2018 · PMID 30316136 · doi