Advances in Molecular Biomarkers in Cardiology

Cardiovascular diseases (CVD) represent the leading cause of death in the world despite innovations in therapies and advances in the general management of patients [...].

Biomarkers should ameliorate risk stratification in the general population. Conditions such as diabetes and thyroid diseases might impact cardiac health. Sirtuin-1 and interleukin-27 serum concentration might increase in case of cardiac dysfunction in a patient with type-1 diabetes and Hashimoto's disease, thus suggesting a possible role of both conditions on overall cardiac protection [9].
The need for monitoring patients with end-stage HF is still a matter of debate. Sciaccalunga et al. [10] provided a comprehensive analysis of biomarkers to be adopted for the clinical management and prognostic evaluation of patients with the Left Ventricular Assist Device (LVAD).
The era of precision medicine is promoting advancement in the diagnosis and prognosis of CVD. Elwazir et al. [11] proposed the use of specific angiogenesis-related long non-coding RNAs (lncRNAs) for the general assessment of individuals at risk for CAD or the identification of the severity of CAD. Indeed, the lncRNA variants were mostly able to predict the severity of CAD-as assessed by the Gensini score-rather than identifying disease susceptibility. Extracellular circulating microRNAs (miRNAs) might provide further insight into distinguishing between CAD and acute coronary syndromes (ACSs). Zhelankin et al. focused their attention on miR-21-5p, miR-146a-5p, and miR-17-5p in CAD and ACS patients [12]. No matter the type of ACSs, miR-21-5p and miR-146a-5p increased, while lower serum concentrations in miR-17-5p were found in those suffering from CAD. Nevertheless, transcriptomic and genetic variability might also impact the development of CAD. For instance, polymorphisms of interferon regulatory factor 5 might effectively alter the cardiometabolic profile of individuals, thus predisposing them to atherosclerosis and its consequences [13].
Nevertheless, despite the great efforts from the scientific community, the way for the identification of the perfect biomarkers of plaque instability is too far from being completed [14]. Genomics, transcriptomics, proteomics, and other common circulating biomarkers are not eventually able to identify the point-break of the atherosclerotic plaque: further research should be dedicated to this interesting and revolutionary issue [14].
Finally, this Special Issue also dealt with some peculiar aspects of CVD. The prognosis of patients with atrial ischemia (AI) is still a matter of debate. The literature is scant on this issue. Kacprzak et al. [15] demonstrated no role for N-terminal pro-atrial natriuretic peptide in predicting AI in patients with myocardial infarction, although it predicted major adverse cardiovascular events.
The worldwide impact of the SARS-CoV-2 pandemic forced physicians to better understand the pathogenesis of the disease in order to counteract adverse events. Hopp et al. [16] provided exciting research that mixed computational and clinical approaches for the evaluation of the role of heme in the pathogenesis of systemic lesions related to the COVID-19 infection.
Finally, an interesting overview of the mechanism and possible therapeutic target for the treatment of venous thromboembolism in patients with cancer has been performed by Canonico et al. [17]. Further insights should be provided by next-generation clinical trials in order to better understand the best approach for the management of these patients.
This Special Issue collected intriguing proposals for the diagnosis, management, and prognostic stratification of patients with CAD and HF. The authors tried to shed light on the field of biomarkers in CVD by promoting their innovative research dealing with molecular aspects and clinical perspectives. Further research is welcomed for improving knowledge of CVD and its prevention/management.

Conflicts of Interest:
The authors declare no conflict of interest.