CoronaryAtlas logo
CoronaryAtlas
Lactate
Pathway / Off-pathway / systemic markers

Lactate

metabolite

Lactate elevation reflects myocardial anaerobic metabolism and hypoxia during acute coronary syndrome.

Pathway placement
Cascade stepOff-pathway / systemic markers
Confidencehigh
RationaleACS diagnosis biomarker and myocardial energy-metabolism indicator; off-pathway systemic marker.
Also acts inMyocardial injury
Druggability
Not assessed (no mapped human gene target).

Type I vs non-Type I discrimination

ScoresShared / rises in both
R — rupture / Type-I
67
C — non-Type-I
53
A — assay feasibility
96
E — evidence strength
86
T1DI (composite)
47
Specificity differential (R−C)+13.4
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 0
2hypovolemia / dehydrationmag 2
2tachyarrhythmiamag 2
2hypoxemia / respiratory failuremag 1
2hypertensive emergencymag 1
2high-demand / peri-operative stressmag 2
3sudden cardiac deathmag 2
4aPCI-related periproceduralmag 2
4bstent thrombosisn/a
4cin-stent restenosisn/a
5CABG-relatedmag 2
Coverage: 10/12 axes with evidence
Tier: deep-scored (abstract-extracted) · 22 supporting references. See the discrimination table for all markers.

Assay & specimen

Validated clinical assay
Specimen
Plasma (fluoride) or whole blood (blood gas)
Collection tube
Sodium fluoride/K-oxalate (grey-top) · Lithium heparin (green-top)
Method / principle
Enzymatic amperometric (blood gas) or colorimetric
Reagent / substrate
Lactate oxidase → H2O2, amperometric or Trinder
Platform
Blood-gas analyzer / POC / chemistry analyzer
Turnaround · availability
STAT · Universal

Literature evidence(4)