Djuric Dragan, Bajic Zorislava, Radisavljevic Nina, Sobot Tanja, Mutavdzin Krneta Slavica, Stankovic Sanja, Skrbic Ranko
Institute of Medical Physiology "Richard Burian", Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Centre for Biomedical Research, Faculty of Medicine, University of Banja Luka, 78 000 Banja Luka, Bosnia and Herzegovina.
Int J Mol Sci. 2025 Aug 23;26(17):8186. doi: 10.3390/ijms26178186.
As the leading cause of global mortality, cardiovascular diseases demand improved and innovative strategies for early detection and risk assessment to enhance prevention and timely treatment. This comprehensive review examines the potential of combining high-sensitivity cardiac troponins (hs-cTns) and homocysteine (Hcy) as complementary biomarkers for enhanced cardiovascular risk prediction. hs-cTn assays have revolutionized cardiovascular diagnostics by enabling the detection of minimal myocardial injury, improving early diagnosis of acute coronary syndrome, and providing robust prognostic information in both symptomatic and asymptomatic populations. Hcy, while established as a marker of vascular dysfunction, presents an interpretative challenge due to multiple confounding factors and inconsistent therapeutic responses. Emerging evidence demonstrates significant correlations between elevated Hcy and troponins across various clinical conditions, suggesting that their combined assessment-reflecting both myocardial injury and vascular dysfunction-may improve cardiovascular risk stratification. While initial findings are promising, additional studies are required to validate the clinical value of the combined marker approach. Future development of personalized interpretation algorithms, and multi-marker panels incorporating these biomarkers, may significantly advance cardiovascular medicine and enable more effective population-specific risk management strategies.
作为全球死亡的主要原因，心血管疾病需要改进和创新的早期检测与风险评估策略，以加强预防和及时治疗。本综述探讨了联合使用高敏心肌肌钙蛋白（hs-cTn）和同型半胱氨酸（Hcy）作为补充生物标志物以增强心血管风险预测的潜力。hs-cTn检测通过能够检测出微小的心肌损伤、改善急性冠状动脉综合征的早期诊断以及为有症状和无症状人群提供可靠的预后信息，彻底改变了心血管诊断。Hcy虽然已被确立为血管功能障碍的标志物，但由于多种混杂因素和不一致的治疗反应，在解释上存在挑战。新出现的证据表明，在各种临床情况下，Hcy升高与肌钙蛋白之间存在显著相关性，这表明它们的联合评估——反映心肌损伤和血管功能障碍两者——可能改善心血管风险分层。虽然初步结果很有希望，但还需要更多研究来验证联合标志物方法的临床价值。个性化解释算法以及纳入这些生物标志物的多标志物组合的未来发展，可能会显著推动心血管医学的发展，并实现更有效的针对特定人群的风险管理策略。
