Advancements in Biomarkers for Early Detection and Risk Stratification of Cardiovascular Diseases—A Literature Review

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports Pub Date : 2025-05-26 DOI:10.1002/hsr2.70878

Abubakar Nazir, Awais Nazir, Usama Afzaal, Shafaq Aman, Safi ur Rehman Sadiq, Ozoemena Z. Akah, Muhammad Shah Wali Jamal, Syed Zawahir Hassan

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Abstract

Introduction

CVDs is a leading cause of morbidity, mortality, and healthcare expenditure worldwide. Identifying individuals at risk or in the incipient stages of disease is instrumental in enabling timely interventions, preventive measures, and tailored treatment regimens. The landscape of CVDs is complicated by their heterogeneity, encompassing a spectrum of conditions such as coronary artery disease, heart failure, arrhythmias, and valvular disorders. In recent years, the integration of biomarkers into cardiovascular medicine has emerged as a paradigm-shifting approach with the potential to revolutionize early detection and risk stratification. By synthesizing a multitude of studies, we aim to provide a comprehensive resource that illuminates the transformative potential of biomarkers in ushering in a new era of precision cardiovascular medicine.

Aim

To identify the biomarkers for the detection and diagnosis of CVDs.

Materials and Methods

This review examines key studies from 2015 to the present that investigate the impact of cardiac biomarkers on cardiovascular outcomes. Data were gathered from PubMed, Cochrane Library, and Embase to ensure a comprehensive analysis. The review focuses on various cardiac biomarkers, assessing their levels and changes in relation to cardiovascular health, with special emphasis on advanced biomarkers such as proteomic and metabolomic markers in cardiovascular disease (CVD) diagnosis. Peer-reviewed studies published in English that evaluated the diagnostic, prognostic, or therapeutic role of cardiac biomarkers were included, with priority given to clinical trials, cohort studies, systematic reviews, and meta-analyses providing quantitative biomarker data. Studies unrelated to cardiac biomarkers, case reports, editorials, conference abstracts, and those with small sample sizes or insufficient methodological rigor were excluded. The review also accounts for potential confounding factors and research limitations, ensuring a balanced assessment of the literature. By synthesizing data from academic papers, clinical reports, and research articles, this study provides a comprehensive evaluation of the evolving role of cardiac biomarkers in CVD diagnosis and risk stratification.

Results

Biomarkers play a pivotal role in cardiovascular disease risk prediction, diagnosis, and treatment by providing dynamic biological insights. High-sensitivity cardiac troponins (hs-cTn) enhance myocardial injury detection, while circulating microRNAs (miR-208, miR-499) serve as early indicators of myocardial infarction and heart failure. Lipoprotein(a) [Lp(a)] predicts long-term cardiovascular risk, and inflammatory biomarkers such as C-reactive protein (CRP) and interleukin-6 (IL-6) are linked to adverse outcomes. Multi-biomarker panels, such as hs-cTn with B-type natriuretic peptide (BNP), improve heart failure prognosis, while metabolomic profiling enables precision medicine. Additionally, biomarkers like BNP and NT-proBNP facilitate real-time therapeutic monitoring. These findings underscore the critical role of biomarkers in refining risk stratification, improving diagnostic accuracy, and enabling personalized treatment strategies in cardiovascular medicine.

Conclusion

The advancement of cardiovascular biomarkers has significantly enhanced early detection, risk stratification, and personalized treatment. Emerging biomarkers, including genetic variants, metabolomics, microRNAs, and imaging-based markers, provide deeper insights into disease mechanisms. Integrating multi-omic approaches with artificial intelligence may further refine predictive accuracy and therapeutic decision-making. However, clinical translation requires rigorous validation through large-scale, multicenter studies to ensure reliability and applicability across diverse populations. Standardization, cost-effectiveness assessments, and the development of biomarker panels are essential for clinical adoption. Future research should focus on bridging discovery and implementation, advancing precision medicine to improve cardiovascular outcomes.

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心血管疾病早期检测和风险分层的生物标志物研究进展

心血管疾病是世界范围内发病率、死亡率和医疗支出的主要原因。确定有风险或处于疾病初期阶段的个人有助于及时干预、采取预防措施和制定有针对性的治疗方案。心血管疾病的情况因其异质性而复杂，包括冠状动脉疾病、心力衰竭、心律失常和瓣膜疾病等一系列疾病。近年来，将生物标志物整合到心血管医学中已经成为一种范式转变的方法，有可能彻底改变早期发现和风险分层。通过综合大量的研究，我们的目标是提供一个全面的资源，阐明生物标志物在引领精准心血管医学新时代的变革潜力。目的寻找检测和诊断心血管疾病的生物标志物。材料和方法本综述回顾了2015年至今研究心脏生物标志物对心血管预后影响的关键研究。数据从PubMed、Cochrane图书馆和Embase收集，以确保全面分析。本文综述了各种心脏生物标志物，评估了它们的水平和变化与心血管健康的关系，特别强调了心血管疾病（CVD）诊断中的先进生物标志物，如蛋白质组学和代谢组学标志物。评估心脏生物标志物的诊断、预后或治疗作用的英文同行评议研究被纳入，优先考虑临床试验、队列研究、系统评价和提供定量生物标志物数据的荟萃分析。排除与心脏生物标志物无关的研究、病例报告、社论、会议摘要以及样本量小或方法学不够严谨的研究。该综述还考虑了潜在的混杂因素和研究局限性，确保了对文献的平衡评估。通过综合学术论文、临床报告和研究文章的数据，本研究全面评估了心脏生物标志物在心血管疾病诊断和风险分层中的作用。结果生物标志物通过提供动态生物学信息，在心血管疾病的风险预测、诊断和治疗中发挥着关键作用。高灵敏度心肌肌钙蛋白（hs-cTn）增强心肌损伤检测，而循环microrna （miR-208、miR-499）可作为心肌梗死和心力衰竭的早期指标。脂蛋白(a) [Lp(a)]预测长期心血管风险，炎症生物标志物如c反应蛋白（CRP）和白细胞介素-6 （IL-6）与不良结局有关。多生物标志物面板，如hs-cTn与b型利钠肽（BNP），可改善心力衰竭预后，而代谢组学分析可实现精准医学。此外，BNP和NT-proBNP等生物标志物有助于实时监测治疗情况。这些发现强调了生物标志物在心血管医学中细化风险分层、提高诊断准确性和实现个性化治疗策略方面的关键作用。结论心血管生物标志物的进步显著提高了心血管疾病的早期发现、风险分层和个性化治疗。新兴的生物标志物，包括遗传变异、代谢组学、microrna和基于成像的标志物，为疾病机制提供了更深入的见解。将多组学方法与人工智能相结合可以进一步提高预测准确性和治疗决策。然而，临床翻译需要通过大规模、多中心的研究进行严格的验证，以确保在不同人群中的可靠性和适用性。标准化、成本效益评估和生物标志物面板的开发对临床应用至关重要。未来的研究应集中在发现和实施之间的桥梁，推进精准医学以改善心血管疾病的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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