| Dragan M. DJURIC1* and Manole COJOCARU2
Abstract: Cardiometabolic diseases represent a major global health challenge characterized by a complex interplay between metabolic dysfunction, vascular injury, chronic inflammation, oxidative stress, and progressive myocardial damage. In recent years, circulating biomarkers have become increasingly important for the early detection of subclinical cardiovascular injury and for improved risk stratification in cardiometabolic disorders. Among these biomarkers, homocysteine and high-sensitivity cardiac troponins (hs-cTn) have emerged as complementary indicators of vascular dysfunction and subclinical myocardial injury, respectively. Hyperhomocysteinemia contributes to endothelial dysfunction, oxidative stress, inflammation, thrombogenesis, and accelerated atherosclerosis, whereas hs-troponins provide highly sensitive detection of ongoing cardiomyocyte injury and myocardial stress. Experimental and clinical evidence increasingly supports the concept that combined assessment of homocysteine and hs-troponins may provide superior prognostic and diagnostic information compared with either biomarker alone. Mechanistic studies have demonstrated that homocysteine-mediated oxidative stress, mitochondrial dysfunction, protein homocysteinylation, and endothelial injury contribute to myocardial remodeling and cardiomyocyte damage associated with hs-troponin release. This review summarizes the historical foundations, molecular mechanisms, experimental evidence, and translational implications of combined homocysteine and hs-troponin assessment in cardiometabolic diseases. Particular emphasis is placed on pioneering discoveries by McCully and Jakubowski, as well as recent contributions from Djuric and coworkers investigating integrated biomarker approaches in experimental cardiometabolic models. Keywords: biomarkers; cardiometabolic disease; high-sensitivity troponins; homocysteine; subclinical myocardial injury DOI 10.56082/annalsarscibio.2026.1.71 Read full article 1 Institute of Medical Physiology “Richard Burian”, Faculty of Medicine, University of Belgrade, str. Visegradska 26/2, 11000 Belgrade, Serbia 2 Academy of Romanian Scientists and Titu Maiorescu University, Faculty of Medicine of Bucharest, Romania
*Corresponding author e-mail: dr_djuric@yahoo.com, dragan.djuric@med.bg.ac.rs |
PUBLISHED in Annals Academy of Romanian Scientists Series on Biology,
ISSN ONLINE85 – 4177
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