serotonin
metaboliteSerotonin is stored in and released from platelet α-granules during activation, promoting vasoconstriction and platelet–platelet recruitment at the thrombotic site.
Pathway placement
Cascade stepPlatelet adhesion & activation
Confidencemedium
RationalePlatelet α-granule cargo; released during activation and aggregation.
Also acts inSystemic / off-pathway
Druggability
Not assessed (no mapped human gene target).
Type I vs non-Type I discrimination
ScoresShared / rises in both
R — rupture / Type-I67
C — non-Type-I54
A — assay feasibility42
E — evidence strength37
T1DI (composite)9
Specificity differential (R−C)+12.8
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 0
2anemia / acute blood lossn/a
2hypovolemia / dehydrationmag 2
2tachyarrhythmian/a
2hypoxemia / respiratory failuremag 2
2hypertensive emergencyn/a
2high-demand / peri-operative stressmag 2
3sudden cardiac deathmag 1
4aPCI-related periproceduralmag 2
4bstent thrombosisn/a
4cin-stent restenosismag 2
5CABG-relatedmag 2
Coverage: 8/12 axes with evidence
Tier: deep-scored (abstract-extracted) · 15 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)
- Biomarkers of in vivo platelet activation in coronary artery disease: a systematic review and meta-analysis: communication from the SSC of the ISTH.Journal of thrombosis and haemostasis : JTH · 2025 · PMID 40685139 · doi
- Anxiety disturbs the blood plasma metabolome in acute coronary syndrome patients.Scientific reports · 2021 · PMID 34145340 · doi
- rLj-RGD3, a novel recombinant toxin protein from Lampetra japonica, prevents coronary thrombosis-induced acute myocardial infarction by inhibiting platelet functions in rats.Biochemical and biophysical research communications · 2018 · PMID 29407168 · doi
- Platelet depletion, platelet activation and coagulation during treatment with hemodialysis.Scandinavian journal of clinical and laboratory investigation · 2011 · PMID 21303224 · doi
Clinical trials(2)
- A Prospective, Single-center, Randomized Study to Evaluate the Effect of Sarpogrelate, a Selective Serotonin Receptor Antagonist, and High Dose Statin on the Reduction of Coronary Spasm in the Patients With Variant AnginaNCT01674686 · PHASE4 · UNKNOWN · Sarpogrelate, Atorvastatin
- Acute Myocardial Necrosis and Depression: Antiplatelet Effect of Reuptake Inhibition of Serotonin: The ANDROS StudyNCT02463110 · PHASE4 · TERMINATED · Sertraline, No treatment, Placebo