cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2025-40-1-19-27cardiotomsk-2629Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESСердечные тропонины: от молекулярнобиологических механизмов к новым перспективам в диагностике и прогнозировании исходов сердечнососудистых заболеваний (обзор литературы)Cardiac troponins: mechanisms of release and new options for diagnosis and prognosis of cardiovascular disease (literature review)https://orcid.org/0000-0002-2812-959XИвановаА. А.IvanovaA. A.

Иванова Анна Александровна, младший научный сотрудник, отдел фундаментальных и прикладных аспектов ожирения

101990, Москва, пер. Петроверигский, 10, стр. 3

Anna А. Ivanova, Junior Research Scientist, Department of Fundamental and Practical Aspects of Obesity

10, build. 3, Petroverigsky per., Moscow, 101990

annaivanova12121@yandex.ruhttps://orcid.org/0000-0001-9305-6713ТимофеевЮ. С.TimofeevYu. S.

Тимофеев Юрий Сергеевич, канд. мед. наук, старший научный сотрудник, отдел фундаментальных и прикладных аспектов ожирения, руководитель лаборатории изучения биохимических маркеров риска хронических неинфекционных заболеваний им. Н.В. Перовой

101990, Москва, пер. Петроверигский, 10, стр. 3

Yuriy S. Timofeev, Cand. Sci. (Med.), Senior Research Scientist, Department of Fundamental and Practical Aspects of Obesity, Head of the Laboratory for the Study of Biochemical Risk Markers of Chronic NonCommunicable Diseases named after N.V. Perova

10, build. 3, Petroverigsky per., Moscow, 101990

YTimofeev@gnicpm.ruhttps://orcid.org/0000-0001-8665-9129МетельскаяВ. А.MetelskayaV. A.

Метельская Виктория Алексеевна, д-р биол. наук, профессор, главный научный сотрудник, лаборатория изучения биохимических маркеров риска хронических неинфекционных заболеваний им. Н.В. Перовой, НМИЦ терапии и профилактической медицины Минздрава России, Москва; профессор, кафедра медицинской биохимии и иммунопатологии, РМАНПО Минздрава России

101990, Москва, пер. Петроверигский, 10, стр. 3,

125993, Москва, ул. Баррикадная, 2/1, стр. 1

Victoria A. Metelskaya, Dr. Sci. (Bio.), Professor, Chief Research Scientist, Laboratory for the Study of Biochemical Risk Markers of Chronic Non-Communicable Diseases named after N.V. Perova, NMRC TPM, Moscow; Professor, Department of Medical Biochemistry and Immunopathology, RMACPE

10, build. 3, Petroverigsky per., Moscow, 101990, 

2/1, build. 1, Barikadnaya str., Moscow, 125993

VMetelskaya@gnicpm.ruhttps://orcid.org/0000-0002-5384-3795ДжиоеваО. Н.DzhioevaO. N.

Джиоева Ольга Николаевна, д-р мед. наук, ведущий научный сотрудник, отдел фундаментальных и прикладных аспектов ожирения, директор Института профессионального образования, руководитель лаборатории кардиовизуализации, вегетативной регуляции и сомнологии, НМИЦ терапии и профилактической медицины Минздрава России, Москва; профессор, кафедра терапии и профилактической медицины, Российский университет медицины Минздрава России

101990, Москва, пер. Петроверигский, 10, стр. 3,

127006, Москва, ул. Долгоруковская, 4

Оlga N. Dzhioeva, Dr. Sci. (Med.), Head of the Laboratory of Cardiac Imaging, Autonomic Regulation and Somnology, Leading Research Scientist, NMRC TPM, Moscow; Professor, Department of Therapy and Preventive Medicine, A.I. Yevdokimov, ROSUNIMED of MOH of Russia

10, build. 3, Petroverigsky per., Moscow, 101990, 

4, Dolgorukovskaya str., Moscow, 127006

ODzhioeva@gnicpm.ruhttps://orcid.org/0000-0003-2087-6483ШальноваС. А.ShalnovaS. A.

Шальнова Светлана Анатольевна, д-р мед. наук, профессор, руководитель отдела эпидемиологии хронических неинфекционных заболеваний 

101990, Москва, пер. Петроверигский, 10, стр. 3

Svetlana A. Shalnova, Dr. Sci. (Med.), Professor, Head of the Epidemiology Department of Chronic Non-communicable Diseases

10, build. 3, Petroverigsky per., Moscow, 101990

sshalnova@gnicpm.ruhttps://orcid.org/0000-0002-4453-8430ДрапкинаО. М.DrapkinaO. M.

Драпкина Оксана Михайловна, д-р мед. наук, профессор, академик РАН, директор НМИЦ терапии и профилактической медицины Минздрава России, Москва; заведующий кафедрой терапии и профилактической медицины, Российский университет медицины Минздрава России

101990, Москва, пер. Петроверигский, 10, стр. 3,

127006, Москва, ул. Долгоруковская, 4

Оksana M. Drapkina, Dr. Sci. (Med.), Professor, Academician of the RAS, Director of the NMRC TPM, Moscow; Head of the Department of Therapy and Preventive Medicine, ROSUNIMED of MOH of Russia

10, build. 3, Petroverigsky per., Moscow, 101990, 

4, Dolgorukovskaya str., Moscow, 127006

ODrapkina@gnicpm.ruНациональный медицинский исследовательский центр терапии и профилактической медицины Министерства здравоохранения Российской Федерации (НМИЦ ТПМ Минздрава России)РоссияNational Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation (NMRC TPM)Russian FederationНациональный медицинский исследовательский центр терапии и профилактической медицины Министерства здравоохранения Российской Федерации (НМИЦ ТПМ Минздрава России); Российская медицинская академия непрерывного профессионального образования Министерства здравоохранения Российской Федерации (РМАНПО Минздрава России)РоссияNational Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation (NMRC TPM); Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation (RMACPE)Russian FederationНациональный медицинский исследовательский центр терапии и профилактической медицины Министерства здравоохранения Российской Федерации (НМИЦ ТПМ Минздрава России); Российский университет медицины Министерства здравоохранения Российской Федерации (Российский университет медицины Минздрава России)РоссияNational Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation (NMRC TPM); Russian University of Medicine of the Ministry of Health of the Russian Federation (ROSUNIMED of MOH of Russia)Russian Federation2025120420254011927Copyright © Иванова А.А., Тимофеев Ю.С., Метельская В.А., Джиоева О.Н., Шальнова С.А., Драпкина О.М., 20252025Иванова А.А., Тимофеев Ю.С., Метельская В.А., Джиоева О.Н., Шальнова С.А., Драпкина О.М.Ivanova A.A., Timofeev Y.S., Metelskaya V.A., Dzhioeva O.N., Shalnova S.A., Drapkina O.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/2629

Наиболее современные высокочувствительные методы оценки уровня сердечных тропонинов (cTn) в сыворотке крови позволяют определять их концентрацию у большинства лиц в популяции, что делает возможным обнаружение субклинического повреждения миокарда. Актуальные данные о молекулярно-биологических механизмах высвобождения тропонина объясняют наличие ассоциаций между его уровнем и развитием неблагоприятных сердечно-сосудистых событий как у бессимптомных лиц, так и у пациентов с сердечно-сосудистыми заболеваниями (ССЗ).

Цель обзора: обобщение имеющихся в литературе данных о лабораторных методах определения и механизмах высвобождения cTn, а также о возможностях применения указанных маркеров для диагностики ССЗ и оценки прогноза пациентов в различных клинических случаях. Обсуждаются существующие проблемы в области методологии определения данных биомаркеров и возможные пути их решения. Кроме того, в обзоре затрагиваются вопросы рестратификации сердечно-сосудистого риска в общей популяции при помощи измерения уровня cTn, а также их применение в группах пациентов с отягощенным сердечно-сосудистым анамнезом, в частности у лиц с ишемической болезнью сердца (ИБС), перенесенным острым нарушением мозгового кровообращения (ОНМК), хронической сердечной недостаточностью (ХСН). Использование cTn в этих группах пациентов может стать эффективным инструментом персонализированной первичной и вторичной профилактики. В обзоре продемонстрировано, что cTn в настоящее время являются одними из наиболее перспективных биомаркеров ССЗ, поскольку методы их измерения обладают высокой воспроизводимостью и специфичностью, а анализ результатов их определения может влиять на тактику ведения пациентов в широком спектре клинических ситуаций.

The modern high-sensitivity methods for cardiac troponin measurement make it possible to determine their concentration in the majority of individuals in the population, which makes it possible to detect subclinical myocardial damage. Current data on the molecular mechanisms of troponin release explain the associations between troponin levels and the development of adverse cardiovascular events in both asymptomatic individuals and patients with cardiovascular disease.

Aim: To summarize the available data on laboratory methods for determining cardiac troponins and the mechanisms of their release, as well as the opportunities to use them for the diagnosis and prognosis of cardiovascular diseases in various clinical situations. Existing problems in the field of methodology for determining these biomarkers and possible ways to solve them are discussed. This article also addresses the issues of restratification of cardiovascular risk in the general population using cardiac troponins, as well as the use of these markers in groups of patients with a history of cardiovascular disease (patients with coronary heart disease, stroke, chronic heart failure). The use of troponins in these patients may help to individualize primary and secondary prevention. The review demonstrates that cardiac troponins are currently one of the most promising biomarkers of cardiovascular diseases, since they have high reproducibility and specificity, and their determination can influence the management of patients in a wide range of clinical situations.

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The authors declare that there are no conflicts of interest present.