Biochemistry & Pharmacology: Open Access
Open Access

Biochemical Biomarkers for the Early Diagnosis and Prognosis of Cardiovascular Disorders

Lukas Feldmann^{* *}Correspondence: Lukas Feldmann, Department of Cardiovascular Medicine, Vienna Institute of Clinical Biochemistry, Vienna, Austria, Email:

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About the Study

Cardiovascular Diseases (CVDs) remain the leading cause of death globally, necessitating the urgent need for efficient strategies in their early detection and prognosis. Over the last two decades, the field of cardiovascular diagnostics has increasingly shifted toward identifying and validating biochemical biomarkers that provide insight into disease progression, therapeutic response, and potential outcomes. Biomarkers are objective, quantifiable indicators of physiological and pathological processes or pharmacologic responses to a therapeutic intervention. In the context of CVDs, such markers not only aid in confirming diagnoses but also help stratify patients based on risk, enabling personalized treatment approaches.

The cornerstone of modern cardiovascular biomarker discovery lies in understanding the underlying pathophysiology of disorders such as atherosclerosis, myocardial infarction, heart failure, and arrhythmias. Troponins, particularly cardiac-specific Troponin I (cTnI) and Troponin T (cTnT), remain the gold standard in the diagnosis of acute myocardial infarction. Their high sensitivity and specificity make them indispensable in clinical settings. However, the discovery of high-sensitivity cardiac troponin assays (hs-cTn) has revolutionized early detection, allowing clinicians to identify myocardial injury even in patients with atypical presentations or silent ischemia.

In addition to troponins, B-type natriuretic peptide (BNP) and its inactive fragment NT-proBNP are vital markers in heart failure diagnosis and prognosis. Elevated levels of these peptides correlate with ventricular stress and have been strongly associated with poor clinical outcomes. C-reactive protein (CRP), especially in its high-sensitivity form (hs-CRP), serves as a general marker of systemic inflammation and has predictive value in assessing the risk of future cardiovascular events. Although it lacks specificity, hs-CRP has been valuable in primary prevention strategies, especially in asymptomatic individuals.

Emerging biomarkers such as growth differentiation factor-15, galectin-3, and soluble ST2 (sST2) have garnered attention due to their roles in inflammation, fibrosis, and myocardial stress. sST2, in particular, has shown promise in predicting mortality in heart failure patients and may outperform natriuretic peptides in certain prognostic applications. Furthermore, lipid-related markers such as lipoprotein-associated phospholipase A2 (Lp-PLA2) and oxidized LDL have been explored for their roles in atherogenesis and vascular inflammation.

With the evolution of omics technologies—proteomics, genomics, and metabolomics—the landscape of biomarker discovery has expanded dramatically. These high-throughput approaches facilitate the identification of novel molecules with potential diagnostic or prognostic relevance. For instance, microRNAs (miRNAs), small non-coding RNAs involved in post-transcriptional gene regulation, are now recognized as potential biomarkers due to their stability in circulation and disease-specific expression profiles. Specific miRNAs, such as miR-1, miR-133a, and miR-208, have been linked to myocardial injury and remodeling.

Another notable advancement is the use of multi-marker panels and machine learning algorithms to integrate multiple biochemical signals, increasing diagnostic accuracy and enabling more precise risk stratification. Combining traditional markers like hs-cTn and NT-proBNP with novel indicators can yield a more comprehensive view of a patient’s cardiovascular status. This is particularly relevant in cases with comorbidities, where single-marker approaches might yield ambiguous results.

Despite these advancements, challenges remain. Issues such as assay standardization, biological variability, and clinical validation limit the widespread implementation of certain novel biomarkers. Additionally, cost-effectiveness and accessibility are crucial considerations for integrating biomarker testing into routine care, especially in low-resource settings.

In conclusion, biochemical biomarkers have significantly improved the early diagnosis and prognosis of cardiovascular disorders. From traditional markers like troponins and natriuretic peptides to novel candidates uncovered by omics technologies, these molecules offer insights into disease mechanisms and patient outcomes. While the integration of multi-marker strategies and artificial intelligence holds promise, further research is essential to validate these tools and translate them into clinical practice. The continued evolution of cardiovascular biomarker research will likely play a pivotal role in the future of personalized medicine, ultimately enhancing patient care and outcomes in cardiology.