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L-lactic acid
Pathway / Off-pathway / systemic markers

L-lactic acid

metabolite

L-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 non-Type I discrimination

ScoresLow-confidence (proxy)
R — rupture / Type-I
62
C — non-Type-I
56
A — assay feasibility
42
E — evidence strength
26
T1DI (composite)
6
Specificity differential (R−C)+5.9
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.
No non-Type-I axis 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)