Non-coding RNA biomarkers in cardiovascular disease

Cardiovascular disease (CVD) persists as the foremost global health burden, despite significant advances in its prevention, diagnostic methodologies, and therapeutic interventions. The prevalence of CVD is escalating, particularly within low- and middle-income countries, a trend attributed to population aging, accelerated urbanization, and disparities in healthcare infrastructure. Hypertension remains the most critical and modifiable risk factor contributing to disease onset. Contemporary diagnostic practices predominantly employ imaging techniques in conjunction with validated biochemical indicators, notably cardiac troponins and natriuretic peptides; however, limitations in sensitivity, specificity, and accessibility restrict early detection and risk stratification. Non-coding RNAs (ncRNAs), characterized by their stability, disease-specific expression, and minimally invasive detectability, have emerged as promising biomarkers that could significantly change CVDs diagnosis, prognosis, and treatment. This review emphasizes the importance of non-coding RNAs as new diagnostic biomarkers for CVDs, compares them to established diagnostic markers, and focuses on the clinical studies and diagnostic uses of non-coding RNAs for CVDs. Additionally, it notes the challenges and limitations related to the standardization and reproducibility of tests employing non-coding RNAs. Although non-coding RNAs may prove to be effective biomarkers for CVDs, there are still challenges that need to be overcome through additional experimental and clinical investigations. This review uniquely integrates recent evidence on ncRNAs as diagnostic biomarkers in cardiovascular disease, emphasizing translational advances, clinical applicability, and current limitations.