midregional proadrenomedullin

peptide

Midregional proadrenomedullin reflects neurohormonal activation and systemic hemodynamic stress following acute MI.

Pathway placement

Cascade stepOff-pathway / systemic markers

Confidencehigh

RationaleNeurohormone and hemodynamic stress marker; off-pathway systemic response to acute cardiac injury.

Druggability

Not assessed (no mapped human gene target).

Type I vs Type II discrimination

ScoresShared / rises in both

R — rupture / Type-I

C — confounder / Type-II

A — assay feasibility

E — evidence strength

T1DI (composite)

Specificity differential (R−C)+8.3

Confounder panel (Type-II drivers)

1sepsis / systemic inflammationmag 2

2anemia / acute blood lossn/a

3hypovolemia / dehydrationn/a

4tachyarrhythmiamag 1

5hypoxemia / respiratory failuremag 2

6hypertensive emergencyn/a

7high-demand / peri-operative stressmag 2

Coverage: 4/7 confounders with evidence

Tier: deep-scored (abstract-extracted) · 18 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

Plasma (EDTA; peptidase-labile — chilled + protease inhibitor)

Collection tube

K2-EDTA, chilled plastic (lavender-top) · Serum separator (gold/red-top, SST)

Method / principle

Competitive/sandwich immunoassay or LC-MS/MS

Reagent / substrate

Anti-peptide antibody; or isotope-labeled internal standard (MS)

Platform

Immunoassay / LC-MS/MS

Turnaround · availability

Send-out / research · Research-grade

Overview of cardiac markers in heart disease.
Clinics in laboratory medicine · 2014 · PMID 24507783 · doi