Proteomic research in clinical samples of cardiovascular diseases

The most lethal diseases to have affected humankind are cardiovascular disorders. For decades, researchers have sought to elucidate the aetiology of heart disease, while clinicians have worked to prevent premature mortality. In recent years, substantial progress has been made in understanding cardiovascular conditions, accompanied by the development of systematic therapeutic strategies that extend patient survival. Advances in proteomics have enabled the analysis of clinical samples with far greater depth than was possible using traditional approaches. Immunoblotting, much like line fishing, is highly specific but inherently inefficient. Proteomics, by contrast, resembles the use of a net, allowing the comprehensive capture of molecular information from limited samples without sacrificing analytical precision. With appropriate methodologies, extensive proteomic information can be obtained through the identification of protein fragments. Studies involving a wide range of sample sources, from solid tissues to biofluids, were included in this review. Tissue samples represent the most informative material for investigating pathological processes at sites of vascular occlusion. However, tissues such as the heart and blood vessels are vital for physiological function and have limited regenerative capacity, rendering these samples rare yet highly valuable. In contrast, biofluid samples are readily accessible. Although they contain more contaminants, such as salts, and yield lower amounts of protein than tissue samples, they nonetheless provide meaningful insights into the circulatory system. Proteomic analyses have revealed that cytoskeletal organisation, extracellular matrix remodelling, immune activation, inflammation, and metabolic processes are involved in most cardiomyopathies, whereas mitochondrial dysfunction, fibrosis, and additional pathways are more prominent in other cardiovascular diseases. Comparative analyses of proteomic data across different cardiovascular conditions and patient cohorts have identified shared molecular pathways, highlighting the capacity of proteomics to uncover multiple dimensions of cardiovascular pathology. Moreover, proteomic profiling facilitates the discovery of candidate biomarkers—whether diagnostic, prognostic, or indicative of disease risk—as well as potential therapeutic targets. These putative biomarkers and targets, however, require validation in larger and more diverse cohorts.