Novel cardiac biomarkers and multiple-marker approach in the early detection, prognosis, and risk stratification of cardiac diseases

Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality worldwide, necessitating innovative diagnostic and prognostic strategies. Traditional biomarkers like C-reactive protein, uric acid, troponin, and natriuretic peptides play crucial roles in CVD management, yet they are often limited by sensitivity and specificity constraints. This narrative review critically examines the emerging landscape of cardiac biomarkers and advocates for a multiple-marker approach to enhance early detection, prognosis, and risk stratification of CVD. In recent years, several novel biomarkers have shown promise in revolutionizing CVD diagnostics. Gamma-glutamyltransferase, microRNAs, endothelial microparticles, placental growth factor, trimethylamine N-oxide, retinol-binding protein 4, copeptin, heart-type fatty acid-binding protein, galectin-3, growth differentiation factor-15, soluble suppression of tumorigenicity 2, fibroblast growth factor 23, and adrenomedullin have emerged as significant indicators of CV health. These biomarkers provide insights into various pathophysiological processes, such as oxidative stress, endothelial dysfunction, inflammation, metabolic disturbances, and myocardial injury. The integration of these novel biomarkers with traditional ones offers a more comprehensive understanding of CVD mechanisms. This multiple-marker approach can improve diagnostic accuracy, allowing for better risk stratification and more personalized treatment strategies. This review underscores the need for continued research to validate the clinical utility of these biomarkers and their potential incorporation into routine clinical practice. By leveraging the strengths of both traditional and novel biomarkers, precise therapeutic plans can be developed, thereby improving the management and prognosis of patients with CVDs. The ongoing exploration and validation of these biomarkers are crucial for advancing CV care and addressing the limitations of current diagnostic tools.