Pathway / Off-pathway / systemic markers

Pyruvate

metabolite

Pyruvate dysregulation reflects myocardial metabolic dysfunction and cardiomyocyte ischemia during acute MI.

Pathway placement

Cascade stepOff-pathway / systemic markers

Confidencemedium

RationaleEnergetic/metabolic biomarker reflecting myocardial metabolic dysregulation and ischemic injury in AMI.

Also acts inMyocardial injury

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)-29.4

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 inflammationn/a

2anemia / acute blood lossn/a

2hypovolemia / dehydrationmag 1

2tachyarrhythmian/a

2hypoxemia / respiratory failuren/a

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: 6/12 axes with evidence

Tier: deep-scored (abstract-extracted) · 8 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(2)

Gemini SERS for Cross-Category Biomarker Detection and Early Warning of Sudden Cardiac Death in Acute Coronary Syndrome.
ACS nano · 2025 · PMID 41131881 · doi
NMR plasma metabolomics study of patients overcoming acute myocardial infarction: in the first 12 h after onset of chest pain with statistical discrimination towards metabolomic biomarkers.
Physiological research · 2020 · PMID 32901496 · doi

Clinical trials(1)

A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Multicenter, Proof of Concept Clinical Study of CTI-01 in Patients Undergoing Major Cardiac Surgery With Cardiopulmonary Bypass
NCT00107666 · PHASE2 · TERMINATED · CTI-01 (ethyl pyruvate)