Translational Biomarkers for Integrated Cardiovascular Disease Risk Assessment: A Multidisciplinary Review with Applications in Precision Medicine

Cardiovascular disease (CVD) continues to be a leading cause of morbidity and mortality, significantly impacting healthcare systems and individual lives. The epidemiology of cardiovascular disease underscores the necessity of understanding both endogenous and modifiable lifestyle risk factors. Critical biochemical markers such as lipid metabolism signatures, inflammatory molecules, endocrine mediators, homeostatic signals (including omics data), and lifestyle factors such as unhealthy dietary habits, physical inactivity, smoking, alcohol abuse, along with anthropometric variables and body composition measurements, play a pivotal role in assessing and managing cardiovascular disease. This progression starts with early vascular and cardiac dysfunctions, advancing to atherosclerosis, and ultimately leading to cardiovascular events. Major adverse cardiovascular events (MACE), including myocardial infarction, stroke, and heart failure, highlight the need for effective and accurate risk stratification and objective assessment. Various CVD risk scores, such as the Framingham Risk Score, SCORE, and the Atherosclerotic Cardiovascular Disease Risk Calculator (ASCVD), provide valuable global frameworks for predicting individual risk based on recognized conventional factors. Additionally, omics markers—which encompass genomic, transcriptomic, epigenomic, proteomic, metabolomic, and metagenomic data—offer deeper insights into the molecular mechanisms underlying CVD, alongside novel lipidomic and immunomic determinants. Integrating these various determinants and risk factors through a comprehensive approach is essential for advancing and implementing precision medicine and nutrition in the management of CVD. This review recapitulates traditional and emerging measures and methods for accurate risk diagnosis, personalized interventions, and precise outcome/evaluation prognosis.