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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">clinmed</journal-id><journal-title-group><journal-title xml:lang="ru">Клиническая медицина</journal-title><trans-title-group xml:lang="en"><trans-title>Clinical Medicine (Russian Journal)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0023-2149</issn><issn pub-type="epub">2412-1339</issn><publisher><publisher-name>ООО «Медицинское информационное агентство»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.30629/0023-2149-2026-104-6-452-462</article-id><article-id custom-type="elpub" pub-id-type="custom">clinmed-1495</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL INVESTIGATIONS</subject></subj-group></article-categories><title-group><article-title>Обоснование нового подхода к поиску потенциальных рентгенологических предикторов инфаркта миокарда у пациентов моложе 50 лет</article-title><trans-title-group xml:lang="en"><trans-title>Validation of a novel approach to identify potential radiologic predictors of myocardial infarction in patients under 50: a pilot study</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5283-5961</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Васильев</surname><given-names>Ю. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Vasilev</surname><given-names>Yu. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Васильев Юрий Александрович — доктор мед. наук, главный врач</p><p>Москва</p></bio><bio xml:lang="en"><p>Yuriy A. Vasilev — Doctor of Medical Sciences, Chief Medical Officer</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8521-4045</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шумская</surname><given-names>Ю. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Shumskaya</surname><given-names>Yu. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шумская Юлия Федоровна — заведующий сектором научных проектов по телемедицине</p><p>Москва</p></bio><bio xml:lang="en"><p>Yuliya F. Shumskaya — Head of Sector for Telemedicine Research Projects</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2161-2140</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Агеев</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ageev</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Агеев Антон Александрович — канд. мед. наук, ассистент кафедры госпитальной терапии № 1, Институт клинической медицины им. Н.В. Склифосовского</p><p>Москва</p></bio><bio xml:lang="en"><p>Anton A. Ageev — Candidate of Medical Sciences, Assistant of the Department of Hospital Therapy No. 1, N.V. Sklifosovskiy Institute of Clinical Medicine</p><p>Moscow</p><p> </p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3496-6466</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Попова</surname><given-names>Л. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Popova</surname><given-names>L. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Попова Людмила Викторовна — канд. мед. наук, доцент, доцент кафедры госпитальной терапии № 1, Институт клинической медицины им. Н.В. Склифосовского</p><p>Москва</p></bio><bio xml:lang="en"><p>Ludmila V. Popova — Candidate of Medical Sciences, Professor, Associate Professor of the Department of Hospital Therapy No. 1, N.V. Sklifosovskiy Institute of Clinical Medicine</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-8499-1077</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рогова</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Rogova</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рогова Елизавета Андреевна — ординатор кафедры кардиологии, функциональной и ультразвуковой диагностики, Институт клинической медицины им. Н.В. Склифосовского</p><p>Москва</p></bio><bio xml:lang="en"><p>Elizaveta А. Rogova — Medical Resident</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1072-2202</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гележе</surname><given-names>П. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Gelezhe</surname><given-names>P. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гележе Павел Борисович — канд. мед. наук, ведущий научный сотрудник, отдел научных медицинских исследований</p><p>Москва</p></bio><bio xml:lang="en"><p>Pavel B. Gelezhe — Candidate of Medical Sciences, Lead Researcher, Medical Research Department</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-6316-7178</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бариев</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Bariev</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бариев Артур Наилевич — врач-рентгенолог, отделение лучевой диагностики №6</p><p>Москва</p></bio><bio xml:lang="en"><p>Artur N. Bariev — Radiologist, Department of Diagnostic Radiology No. 6</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5161-6540</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гончар</surname><given-names>А. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Goncha</surname><given-names>A. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гончар Анна Павловна — канд. мед. наук, врач-рентгенолог, отделение лучевой диагностики</p><p>Москва</p></bio><bio xml:lang="en"><p>Anna P. Gonchar — Candidate of Medical Sciences, Radiologist, Department of Radiation Diagnostics</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6218-3012</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гатин</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Gatin</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гатин Денис Владимирович — врач-рентгенолог, отделение лучевой диагностики № 6</p><p>Москва</p></bio><bio xml:lang="en"><p>Denis V. Gatin — Radiologist, Department of Diagnostic Radiology No. 6</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-1986-6467</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Беженова</surname><given-names>К. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Bezhenova</surname><given-names>K. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Беженова Карина Юрьевна — младший научный сотрудник, сектор научных проектов по телемедицине</p><p>Москва</p></bio><bio xml:lang="en"><p>Karina Yu. Bezhenova — Junior Researcher, Sector for Telemedicine Research Projects</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9199-7229</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Савин</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Savin</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Савин Никита Александрович — канд. физ.-мат. наук, научный сотрудник, отдел научных медицинских исследований</p><p>Москва</p></bio><bio xml:lang="en"><p>Nikita A. Savin — Candidate of Physical and Mathematical Sciences, Researcher, Medical Research Department</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9661-0254</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Решетников</surname><given-names>Р. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Reshetnikov</surname><given-names>R. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Решетников Роман Владимирович — канд. физ.-мат. наук, руководитель научного отдела, отдел научных медицинских исследований</p><p>Москва</p></bio><bio xml:lang="en"><p>Roman V. Reshetnikov — Candidate of Physical and Mathematical Sciences, Head of Department, Medical Research Department</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГБУЗ города Москвы «Научно-практический клинический центр диагностики и телемедицинских технологий Департамента здравоохранения города Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow Center for Diagnostics and Telemedicine</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ГБУЗ города Москвы «Городская клиническая больница им. С.С. Юдина Департамента здравоохранения города Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Moscow City Hospital named after S.S. Yudin of the Department of Health of the City of Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>28</day><month>08</month><year>2026</year></pub-date><volume>104</volume><issue>6</issue><elocation-id>452–462</elocation-id><permissions><copyright-statement>Copyright &amp;#x00A9; Васильев Ю.А., Шумская Ю.Ф., Агеев А.А., Попова Л.В., Рогова Е.А., Гележе П.Б., Бариев А.Н., Гончар А.П., Гатин Д.В., Беженова К.Ю., Савин Н.А., Решетников Р.В., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Васильев Ю.А., Шумская Ю.Ф., Агеев А.А., Попова Л.В., Рогова Е.А., Гележе П.Б., Бариев А.Н., Гончар А.П., Гатин Д.В., Беженова К.Ю., Савин Н.А., Решетников Р.В.</copyright-holder><copyright-holder xml:lang="en">Vasilev Y.A., Shumskaya Y.F., Ageev A.A., Popova L.V., Rogova E.A., Gelezhe P.B., Bariev A.N., Goncha A.P., Gatin D.V., Bezhenova K.Y., Savin N.A., Reshetnikov R.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.clinmedjournal.com/jour/article/view/1495">https://www.clinmedjournal.com/jour/article/view/1495</self-uri><abstract><p>Сердечно-сосудистые заболевания (ССЗ) остаются основной причиной смертности в России. Риск смертности пациентов младше 50 лет с острым инфарктом миокарда (ОИМ) сохраняется высоким. Это обуславливает необходимость поиска дополнительных предикторов ОИМ, включая рентгенологические признаки. Предложен подход, согласно которому прогностическая модель более информативна при включении в нее низкокоррелирующих признаков.</p><sec><title>Цель</title><p>Цель: проверка гипотезы о наличии у пациентов моложе 50 лет с ОИМ уникальных низкокоррелирующих пар признаков, определяемых по данным компьютерной томографии органов грудной клетки (КТ ОГК) до сердечно-сосудистого события, по сравнению с пациентами с ОИМ старше 50 лет.</p></sec><sec><title>Материал и методы</title><p>Материал и методы. Проведено ретроспективное исследование. Включены пациенты с впервые возникшим ОИМ и наличием КТ ОГК, выполненной за 6–12 месяцев до сердечно-сосудистого события. Построены корреляционные матрицы признаков для пациентов моложе и старше 50 лет. Из совокупности пар признаков для молодых пациентов вычтены общие пары с низкой корреляцией. </p></sec><sec><title>Результаты</title><p>Результаты. В исследование включены 59 пациентов, 12 — моложе 50 лет, 47 — старше. Группы различались по числу пациентов с многососудистым поражением, показателям наличия остеопороза и гидроторокса по данным КТ ОГК, среднему показателю размера аорты. В результате анализа было выявлено 12 уникальных пар признаков, которые могут дополнить существующие рисковые модели.</p></sec><sec><title>Выводы</title><p>Выводы. Применение рентгенологических маркеров для улучшения прогноза ССЗ перспективно, однако требует проведения дополнительных проспективных когортных исследований с более крупной выборкой.</p></sec></abstract><trans-abstract xml:lang="en"><p>Cardiovascular diseases (CVDs) continue to be the leading cause of mortality in Russia. Over the past three decades, effective preventive measures have led to a one-third reduction in morbidity rates. However, there remains a significant risk of mortality among patients under 50 years of age who experience acute myocardial infarction (AMI). This highlights the need to identify additional predictors, including radiological features, to enhance prognostic models for CVD. There is an approach suggesting that incorporating low-correlation pairs of features may yield more informative model predictions.</p><sec><title>Aim</title><p>Aim. To evaluate the hypothesis that patients under 50 years of age with AMI exhibit distinct low-correlation pairs of characteristics, as identifi ed by chest computed tomography (CT), compared to patients over 50 years of age with AMI.</p></sec><sec><title>Material and methods</title><p>Material and methods. This was a retrospective study involving patients who experienced their first AMI and had undergone chest CT 6–12 months prior to the cardiovascular event. Correlation matrices were created for patients under 50 years of age and those over 50. Subsequently, pairs of features with low correlation that were common to all patients were removed from the set of feature pairs for the younger group.</p></sec><sec><title>Results</title><p>Results. The study included 59 patients, with 12 under the age of 50 and 47 over 50. The groups diff ered in the prevalence of multivessel lesions, the presence of osteoporosis and hydrothorax as assessed by chest CT, and the average aortic size. By constructing correlation matrices and eliminating common feature pairs with weak correlations, we identified 12 unique feature pairs that could enhance existing risk models.</p></sec><sec><title>Conclusion</title><p>Conclusion. Utilizing radiological markers to improve CVD prognosis shows promise, but further prospective cohort studies with larger sample sizes are necessary to validate these findings.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>острый коронарный синдром</kwd><kwd>острый инфаркт миокарда</kwd><kwd>факторы риска</kwd><kwd>компьютерная томография</kwd><kwd>рентгенологические маркеры</kwd></kwd-group><kwd-group xml:lang="en"><kwd>аcute coronary syndrome</kwd><kwd>acute myocardial infarction</kwd><kwd>risk factors</kwd><kwd>computed tomography</kwd><kwd>radiological markers</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Данная статья подготовлена авторским коллективом в рамках НИР «Переход от пилотирования инноваций к осознанному долгосрочному внедрению».</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Kakorina E.P., Nikitina S.Y. 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