Olink Proteomics in Heart Failure: A Comprehensive Review of Applications From Biomarker Discovery to Pathophysiological Insights and Clinical Implementation

Heart failure (HF) remains a global health challenge characterised by significant clinical heterogeneity, necessitating more precise tools for diagnosis and risk stratification. Olink proteomics, a high-throughput platform based on proximity extension assays (PEAs), has emerged as a powerful technology for exploring the molecular landscape of HF. Despite a growing number of studies utilising this platform, a comprehensive synthesis of its clinical and mechanistic contributions is still lacking. This review systematically examines the application of Olink proteomics across the HF continuum. We synthesised evidence regarding its role in biomarker discovery for early detection and prognosis, its ability to dissect key pathophysiological pathways such as inflammation and fibrosis, and its emerging potential to guide precision medicine. By critically evaluating technological advances, current challenges, and future directions, this review concludes that Olink proteomics is pivotal for transitioning HF management from a phenotype-driven to a mechanism-based paradigm, paving the way for targeted therapies and improved patient outcomes.