Biomarkers · Nov 4, 2026

Next Steps for Cardiovascular Biomarkers: From Measurement to Clinical Decisions

By Daniels LB

Cardiovascular biomarkers have transformed diagnosis and risk assessment, but outside of acute care their results rarely change treatment. This editorial argues that the next phase of biomarker research should focus on linking results to defined clinical actions. Guidelines now support natriuretic peptide and high-sensitivity cardiac troponin testing to identify pre-heart failure in adults with diabetes and other high-risk groups. However, trials are still needed to establish what a positive result should trigger, including whether specific drug classes, such as renin-angiotensin system inhibitors, offer greater benefit in biomarker-positive patients. Recent negative trials of therapies aimed at lowering lipoprotein(a) and interleukin-6 underscore the difference between using biomarkers to select patients and treating them as therapeutic targets. Dipeptidyl peptidase 3, developed in parallel with a neutralizing antibody being evaluated for treatment of shock, illustrates a model in which assay and therapy advance together. Progress will depend on validated thresholds, drug class trials, companion diagnostics, and reimbursement.

doi.org/10.1080/1354750x.2026.2759682PubMed 42979860Biomarkers