Multi-omics based biomarkers in acute coronary syndrome: Towards precision in cardiovascular medicine
Yash Paul Sharma1, Ankur Mittal1, Kraticka Singhal1
1Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India.
Background:
Acute coronary syndrome (ACS) remains a leading cause of cardiovascular morbidity and mortality worldwide. High-throughput omics technologies offer opportunities for more comprehensive understanding of ACS pathophysiology.
Methods:
A systematic review was conducted in accordance with PRISMA 2020 guidelines. Searches of PubMed/MEDLINE, Scopus, Web of Science and Embase (January 2015-April 2026) identified 8731 records. Study quality and risk of bias were assessed for studies selected for detailed evidence synthesis using the Newcastle-Ottawa Scale, QUADAS-2 and AMSTAR-2.
Results:
Systematic searching identified 866 primary studies and 47 systematic reviews. Detailed synthesis focused on the most robust and replicated biomarker candidates where ceramide risk scores, GDF-15, MPO and miR-208a emerged as particularly promising while multi-omics machine-learning models improved ACS classification.
Conclusions:
Multi-omics approaches may enhance precision risk stratification in ACS although prospective validation and standardization remain essential.
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