Mannitol

metabolite

A polyol metabolite reflecting myocardial metabolic stress and serving as a prognostic marker in acute coronary syndrome.

Pathway placement

Cascade stepMyocardial injury (shared endpoint)

Confidencelow

RationaleCarbohydrate metabolite associated with MI risk and prognostic stratification in ACS.

Druggability

Not assessed (no mapped human gene target).

Type I vs Type II discrimination

ScoresIndeterminate

R — rupture / Type-I

—

C — confounder / Type-II

A — assay feasibility

E — evidence strength

T1DI (composite)

Specificity differential (R−C)-18.3

Confounder panel (Type-II drivers)

1sepsis / systemic inflammationn/a

2anemia / acute blood lossn/a

3hypovolemia / dehydrationmag 1

4tachyarrhythmiamag 1

5hypoxemia / respiratory failuren/a

6hypertensive emergencyn/a

7high-demand / peri-operative stressn/a

Coverage: 2/7 confounders with evidence

Tier: deep-scored (abstract-extracted) · 2 supporting references. See the discrimination table for all markers.

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