Recent Advances in Biomarkers for Cardiovascular Disease

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (28 February 2026) | Viewed by 4575

Special Issue Editor

Special Issue Information

Dear Colleagues,

Cardiovascular disease is still the leading cause of morbidity and mortality worldwide despite the great diagnostic and therapeutic progress made in recent decades. Intervention using cardiovascular risk factors is seen as the best long-term solution to improve the outcome of these patients. Therefore, their identification and appropriate therapeutic approach are of the utmost importance.

Some of them are behavioral risk factors, such as unhealthy diet, physical inactivity, tobacco use, and excessive alcohol consumption. Although it is not difficult to correct them, their prevalence remains high because the population is not fully aware of their harmful effect on health. The continuous and long-term action of behavioral risk factors is associated with overweight and obesity, atherogenic dyslipidemia, diabetes, and hypertension, all of which are strong risk factors for cardiovascular disease. The risk of stroke, ischemic heart disease, peripheral artery disease, heart failure, and death that an individual has increases exponentially as risk factors accumulate because they potentiate each other and accelerate target organ damage.

Although there are many different risk factors that increase the likelihood of developing cardiovascular disease, they are largely preventable. By implementing a healthy lifestyle and appropriate pharmacological intervention, we can improve the longevity and quality of life of millions of people around the world.

We invite you to share your knowledge and experience by contributing to this Special Issue. Original and review papers that address cardiovascular risk factors in all aspects, from cellular and molecular mechanisms, and pathophysiological links to problems of diagnosis, treatment, and monitoring, are welcome. We look forward to receiving your contributions.

Dr. Manuela Ciocoiu
Guest Editor

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Keywords

  • cardiovascular risk factors
  • hypertension
  • dyslipidemia
  • overweight
  • obesity
  • diabetes mellitus
  • metabolic syndrome
  • atherosclerosis
  • physical inactivity
  • biomarkers
  • cardiovascular disease

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Published Papers (4 papers)

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Research

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11 pages, 1059 KB  
Article
Serum Osteoprotegerin Level Is Not a Localizing Biomarker of Atherosclerosis Affected by Kidney Function
by Anna Maria Bednarek, Aleksander Jerzy Owczarek, Dominika Dziadosz, Magdalena Olszanecka-Glinianowicz and Jerzy Tadeusz Chudek
Diagnostics 2026, 16(5), 786; https://doi.org/10.3390/diagnostics16050786 - 6 Mar 2026
Cited by 1 | Viewed by 527 | Correction
Abstract
Introduction: Osteoprotegerin (OPG) is recognized as an emerging biomarker for atherosclerosis. We hypothesized that atherosclerotic lesions localized across multiple vascular beds would result in greater elevations in OPG levels in the blood. Therefore, our study aimed to assess serum OPG levels and [...] Read more.
Introduction: Osteoprotegerin (OPG) is recognized as an emerging biomarker for atherosclerosis. We hypothesized that atherosclerotic lesions localized across multiple vascular beds would result in greater elevations in OPG levels in the blood. Therefore, our study aimed to assess serum OPG levels and their confounding factors in patients with hemodynamically significant multivessel atherosclerosis in varying locations. Subjects and Methods: A case–control study included 222 selected outpatients aged 50 years or older (46.4% women) with atherosclerosis confirmed by imaging (Doppler ultrasound and CT angiography) treated at a single angiology clinic. Data concerning age, smoking status, comorbidity (hypertension, diabetes mellitus, history of stroke, myocardial infarction, coronary revascularization procedures), medication, lipid profile, serum creatinine, and homocysteine levels were retrieved from medical records. Additionally, serum OPG levels were measured. Patients were divided according to serum OPG levels into terciles and the number of involved vascular beds [carotid artery disease, coronary heart disease (CHD), lower-extremity peripheral artery disease (PAD), abdominal aorta aneurysm (AAA)]. Results: The distribution of carotid artery disease, CHD, PAD, and AAA did not differ across the OPG terciles. Additionally, we did not observe differences in OPG levels between specific and multiple locations of atherosclerotic lesions. Subjects with the highest OPG levels were the oldest (75.0 ± 8.4 vs. 69.8 ± 7.1 years in the lowest tercile; p < 0.001) and were characterized by the worst kidney function (eGFR 60.8 ± 16.8 vs. 74.1 ± 13.5 mL/min/1.73 m2; p < 0.001). Conclusions: The serum OPG level did not reveal the specific location of atherosclerosis. Impaired renal function appears to be the primary determinant of serum OPG levels and a key confounder, complicating the interpretation of serum OPG as a biomarker of atherosclerosis. Full article
(This article belongs to the Special Issue Recent Advances in Biomarkers for Cardiovascular Disease)
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17 pages, 446 KB  
Article
Lipid, Metabolomic and Gut Microbiome Profiles in Long-Term-Hospitalized Cardiac Patients—An Observational and Retrospective Study
by Ionica Grigore, Oana Roxana Ciobotaru, Delia Hînganu, Gabriela Gurau, Elena Stamate, Dana Tutunaru, Radu Sebastian Gavril, Octavian Catalin Ciobotaru and Marius Valeriu Hînganu
Diagnostics 2025, 15(22), 2874; https://doi.org/10.3390/diagnostics15222874 - 13 Nov 2025
Cited by 1 | Viewed by 725
Abstract
Background/Objectives: Long-term hospitalization in cardiac patients is associated with significant metabolic and microbial alterations that may influence disease progression and prognosis. Although lipid imbalances, metabolomic shifts, and gut microbiome dysbiosis have each been linked individually to cardiovascular outcomes, their integrated evaluation in [...] Read more.
Background/Objectives: Long-term hospitalization in cardiac patients is associated with significant metabolic and microbial alterations that may influence disease progression and prognosis. Although lipid imbalances, metabolomic shifts, and gut microbiome dysbiosis have each been linked individually to cardiovascular outcomes, their integrated evaluation in long-term-hospitalized patients remains underexplored. Methods: We conducted a retrospective observational study including 51 cardiac patients hospitalized for more than 25 days, compared with a control group of 41 patients hospitalized for short and intermediate durations (3–24 days). Clinical and demographic data were collected, alongside lipid profiling, metabolomic assessment through liquid chromatography–mass spectrometry (LC-MS), and gut microbiome analysis using GI360™ sequencing. Ethical approval was obtained, and all data were anonymized. Lipid-related findings are exploratory due to the small number of complete measurements. Results: Preliminary lipid trends were characterized by higher levels of LDL, triglycerides, and Lp(a), and lower HDL, in the long-term group. Metabolomic analyses revealed decreased energy-related metabolites (ATP, phosphocreatine ratio), altered amino acid patterns, and increased ketone utilization. Gut microbiome evaluation demonstrated a significant increase in dysbiosis index, with reduced diversity and dominance of potentially pathogenic taxa. These findings were correlated with clinical severity scores. Cross-domain relationships are exploratory and based on associative profiling rather than deep integrative modelling. Conclusions: Long-term hospitalization in cardiac patients is associated with distinct lipid, metabolomic, and gut microbiome profiles that may serve as predictive biomarkers of adverse outcomes. Future studies should validate these findings in larger cohorts and explore their integration into personalized management strategies. Full article
(This article belongs to the Special Issue Recent Advances in Biomarkers for Cardiovascular Disease)
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1 pages, 127 KB  
Correction
Correction: Bednarek et al. Serum Osteoprotegerin Level Is Not a Localizing Biomarker of Atherosclerosis Affected by Kidney Function. Diagnostics 2026, 16, 786
by Anna Maria Bednarek, Aleksander Jerzy Owczarek, Dominika Dziadosz, Magdalena Olszanecka-Glinianowicz and Jerzy Tadeusz Chudek
Diagnostics 2026, 16(7), 1040; https://doi.org/10.3390/diagnostics16071040 - 30 Mar 2026
Viewed by 307
Abstract
In the original publication [...] Full article
(This article belongs to the Special Issue Recent Advances in Biomarkers for Cardiovascular Disease)
23 pages, 11955 KB  
Systematic Review
Evaluating Immune-Inflammatory Indices for Risk Stratification in Cardiovascular Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses
by Hanxin Liu, Pingwu Wang, Lik Hang Wu, Fan Wu, Xinya Zhou, Yuhan Li, Hui Su, Jiayi Zang, Xinchen Ji, Xueling Xiao, Ya-Ke Wu, Leroy Sivappiragasam Pakkiri and Chester Lee Drum
Diagnostics 2025, 15(22), 2862; https://doi.org/10.3390/diagnostics15222862 - 12 Nov 2025
Cited by 4 | Viewed by 2020
Abstract
Background/Objectives: Although systematic reviews and meta-analyses have examined immune-inflammatory indices in cardiovascular disease (CVD), the evidence remains scattered and inconsistent. This umbrella review aims to synthesize findings and evaluate the overall predictive value of these indices for clinical outcomes. Methods: We systematically [...] Read more.
Background/Objectives: Although systematic reviews and meta-analyses have examined immune-inflammatory indices in cardiovascular disease (CVD), the evidence remains scattered and inconsistent. This umbrella review aims to synthesize findings and evaluate the overall predictive value of these indices for clinical outcomes. Methods: We systematically searched PubMed, Cochrane Library, Web of Science, Embase, Scopus, and Medline for systematic reviews with meta-analyses assessing neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), and systemic inflammation response index (SIRI) in patients with CVD. Study quality and certainty of evidence were appraised using AMSTAR-2 and GRADE, respectively. Results: A total of 35 meta-analyses covering 106 unique outcomes were included, of which 87 showed significant associations. Elevated NLR and SII were consistently linked to higher risks of CVD mortality, major adverse cardiovascular events, myocardial infarction, heart failure, and stroke. PLR and SIRI were primarily associated with poor recovery from stroke and increased mortality in ST-elevation myocardial infarction. Specifically, the methodological quality of the included reviews was generally moderate to high according to AMSTAR-2, whereas none of the associations reached high certainty based on GRADE, with most rated as low or very low and about one-quarter as moderate certainty. Conclusions: The overall certainty of evidence remains limited according to GRADE, alongside methodological heterogeneity, population variability, and inconsistent thresholds that further restrict the direct applicability of these findings in clinical practice. Nevertheless, available evidence indicates that elevated immune-inflammatory indices are likely associated with worse clinical outcomes in patients with CVD. Future research should prioritize establishing standardized cutoffs, improving methodological consistency, and validating these indices across diverse populations to support their integration into clinical risk-stratification frameworks. Full article
(This article belongs to the Special Issue Recent Advances in Biomarkers for Cardiovascular Disease)
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