Malondialdehyde

metabolite

MDA is generated by lipid peroxidation and reflects both LDL oxidation and oxidative damage to the endothelial glycocalyx.

Pathway placement

Cascade stepLipid retention & oxidation

Confidencehigh

RationaleLipid peroxidation end-product; marks oxidative LDL modification and endothelial injury in smoking.

Also acts inVascular inflammation, Endothelial activation/erosion

Druggability

Not assessed (no mapped human gene target).

Type I vs non-Type I discrimination

ScoresIndeterminate

R — rupture / Type-I

—

C — non-Type-I

A — assay feasibility

E — evidence strength

T1DI (composite)

Specificity differential (R−C)-30.8

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 lossn/a

2hypovolemia / dehydrationn/a

2tachyarrhythmiamag 1

2hypoxemia / respiratory failuremag 1

2hypertensive emergencymag 1

2high-demand / peri-operative stressmag 1

3sudden cardiac deathmag 1

4aPCI-related periproceduralmag 2

4bstent thrombosisn/a

4cin-stent restenosismag 2

5CABG-relatedn/a

Coverage: 8/12 axes with evidence

Tier: deep-scored (abstract-extracted) · 22 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(3)

Cigarette smoking induced oxidative stress may impair endothelial function and coronary blood flow in angiographically normal coronary arteries.
Circulation journal : official journal of the Japanese Circulation Society · 2006 · PMID 16636496 · doi
Divergent effects of rofecoxib on endothelial function and inflammation in acute coronary syndromes.
International journal of cardiology · 2005 · PMID 16330117 · doi
Role of oxygen free radicals in causing endothelial damage in acute myocardial infarction.
The Journal of the Association of Physicians of India · 2000 · PMID 11273136

Clinical trials(1)

Supplementation of Piperine and Curcumin (Curcuma Xanthorrhiza) Extract in ST Elevation Myocardial Infarction - SPICE STEMI Trial
NCT07149961 · NA · COMPLETED · Curcumin plus Piperine, Placebo capsules