Emergent RNA targets in cardiovascular disease: likely candidates for treatment development

INTRODUCTION: Cardiovascular diseases (CVDs) are a leading cause of morbidity and death worldwide, emphasizing the urgent need for innovative diagnostic and treatment strategies. Increasing evidence indicates that noncoding RNAs (ncRNAs) play critical roles in the molecular mechanisms of CVDs by regulating epigenetic networks, transcriptional programs, and post-transcriptional gene expression. Their dysregulation is consistently linked to most cardiovascular conditions, making ncRNAs promising biomarkers and therapeutic targets. AREAS COVERED: Recent advances in RNA-based technologies have ushered in a new era of precision cardiology. Preclinical studies have demonstrated the potent efficacy of RNA modulation in disease pathways. Ongoing clinical trials are evaluating RNA-based drugs that target key cardiovascular regulators, underscoring the high potential of this approach. However, challenges related to delivery, specificity, toxicity, and cardiac uptake remain to be addressed to enable widespread clinical application. EXPERT OPINION: RNA-based therapeutics have proven to be highly promising approaches for innovation in cardiovascular medicine. However, significant technical challenges still need to be addressed. Improving delivery systems, refining RNA chemistry, and establishing reliable biomarkers will be crucial for integrating these approaches into standard clinical practice. Ongoing research and clinical validation are expected to determine the extent to which RNA-based therapies will enhance future CVD treatment.