Background: Biomarkers are indispensable tools for screening, diagnosis, and prognosis in
cardiovascular diseases and their clinical application increases steadily. As cardiovascular diseases include
various pathophysiological processes, no single biomarker, even natriuretic peptides, can be regarded
as ideal fulfilling all necessary criteria for a comprehensive diagnostic or prognostic assessment
revealing optimal clinical application. Hence, multi-marker approaches using different biomarkers reflecting
different pathophysiologies were highlighted recently. Advances in biomedical technologies
expanded the spectrum of novel blood-derived biomarkers, such as micro-RNA (miRNA) or “omics”-
data potentially providing a more advanced knowledge about pathogenesis of cardiovascular disease.
Conclusion: This review describes the advantages and limitations of blood circulating biomarkers with
regard to proteins, metabolomics and transcriptional level both within single as well as multi-marker
strategies. Moreover, their usefulness is focused on clinical decision-making in cardiovascular diseases.