Metabolomics in cardiovascular diseases: from prevention strategies to domain-specific applications

Cardiovascular diseases (CVD) are the leading cause of death worldwide. Systemic remodeling of metabolism is a major pathophysiological response to cardiac dysfunction and its complications. Metabolomics is thus an important technological platform for discovering new biomarkers, elucidating disease mechanisms, and stratifying patients for personalized therapeutic options.

We summarize the progress in clinical metabolomics across major domains of CVD based on studies published from 2020 to 2025. We focus on large-scale prospective clinical research studies for primary and secondary prevention, highlighting metabolite signatures for risk stratification and outcome prediction. We review specific areas of CVD, including acute coronary syndromes, cardiomyopathy, valvular heart disease, heart failure, atrial fibrillation, and pulmonary artery disease.

Metabolomics provides unique value in CVD risk prediction and biomarker identification across populations, offering complementary information to traditional risk factors. It provides direct readout of systemic metabolic state and enable discovery of metabolic pathways associated with the pathophysiology of CVDs. Metabolomics is therefore an important phenotyping modality in CVD research and clinical care.