Pathway / Endothelial activation & erosion

Noradrenaline

metabolite

Noradrenaline promotes endothelial activation and dysfunction, increases platelet reactivity, and alters thrombus architecture in atherothrombotic MI.

Pathway placement

Cascade stepEndothelial activation & erosion

Confidencemedium

RationaleCatecholamine linked to endothelial damage and dysfunction; affects clot microstructure and platelet activation in STEMI.

Also acts inPlatelet activation

Druggability

Not assessed (no mapped human gene target).

Type I vs Type II discrimination

ScoresType-II-associated

R — rupture / Type-I

—

C — confounder / Type-II

A — assay feasibility

E — evidence strength

T1DI (composite)

Specificity differential (R−C)-51.7

Confounder panel (Type-II drivers)

1sepsis / systemic inflammationn/a

2anemia / acute blood lossmag 2

3hypovolemia / dehydrationn/a

4tachyarrhythmian/a

5hypoxemia / respiratory failuren/a

6hypertensive emergencyn/a

7high-demand / peri-operative stressn/a

Coverage: 1/7 confounders with evidence

Tier: deep-scored (abstract-extracted) · 2 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(4)

12,13-diHOME and noradrenaline are associated with the occurrence of acute myocardial infarction in patients with type 2 diabetes mellitus.
Diabetology & metabolic syndrome · 2023 · PMID 37386486 · doi
The effect of tyramine infusion and exercise on blood flow, coagulation and clot microstructure in healthy individuals.
Thrombosis research · 2018 · PMID 30098458 · doi
Association between sympathoadrenal activation, fibrinolysis, and endothelial damage in septic patients: a prospective study.
Journal of critical care · 2014 · PMID 24581948 · doi
Acute myocardial infarction is associated with endothelial glycocalyx and cell damage and a parallel increase in circulating catecholamines.
Critical care (London, England) · 2013 · PMID 23433357 · doi

Clinical trials(1)

12,13-DHOME and Noradrenaline Are Associated With Occurrence of Acute Myocardial Infarction in Patients With Type 2 Diabetes Mellitus: A Untargeted Metabolomics Study
NCT05601310 · COMPLETED · liquid chromatography-mass spectrometry (LC/MS) analysis