From acute diagnosis to longitudinal risk stratification: a paradigm shift in the clinical role of cardiac biomarkers

This perspective examines the evolving role of cardiac biomarkers from acute diagnostic tools to integral components of longitudinal risk stratification and cardiovascular disease management. Evidence from cohort studies, clinical trials, and high-sensitivity assays demonstrates that biomarkers reflecting myocardial injury, hemodynamic stress, inflammation, fibrosis, and metabolic dysfunction can inform prevention, early detection, acute care, and chronic monitoring. Key implementation strategies include multi-biomarker panels, serial measurements, multi-omics integration, and artificial intelligence-based risk modeling. Challenges such as assay standardization, clinical interpretation, and cost-effectiveness are critically evaluated. Overall, this framework highlights the potential for biomarker-guided approaches to promote more preventive, precise, and patient-centered cardiovascular care.