Molecular mechanisms of cardioprotection: biomarkers, signaling pathways, and emerging molecular signatures in cardiovascular disease

Cardiovascular diseases (CVDs) are the leading cause of worldwide mortality, with myocardial infarction (MI) being one of the most significant clinical indicators. Around 85% of the 17.9 million cardiovascular deaths are due to heart attack and stroke. This comprehensive review focuses on cardiac biomarkers and cardioprotection signaling pathways. This review describes key cardioprotective signaling pathways, including PKCε, RISK (Reperfusion Injury Salvage Kinase), MAPK, NO/cGMP/PKG, and SAFE (Survivor Activating Factor Enhancement), which work together to regulate cardiovascular functions, prevent cellular death, and maintain mitochondrial stability. The physiology of heart injury is examined through the complex interactions of inflammatory processes, necrotic transmissions, self-destruction, and oxidative stress, with particular attention to mitochondrial dysfunction, reactive oxygen species (ROS), and NLRP3 inflammasome activation. A thorough review of traditional and innovative cardiac biomarkers is provided, including long non-coding RNAs, microRNAs (e.g., miR-21, miR-486-5p, miR-126), creatine kinase-MB (CK-MB), cardiac troponins (cTnI/cTnT), inflammatory markers (CRP, IL-6, TNF-α), and natriuretic peptides (BNP/NT-pro BNP). A broad discussion of these novel biomarkers covers their applications in prognosis, screening, and medical assessment, emphasizing their roles in risk evaluation, early detection, and personalized therapy plans. This study offers an extensive perspective on cardiac protection, integrating clinical applications with physiological mechanisms to promote precise cardiovascular treatment and improve patient outcomes.