Peripheral blood RNA biomarkers for cardiovascular disease from bench to bedside: a position paper from the EU-CardioRNA COST action CA17129

Maarten Vanhaverbeke*, Ritienne Attard, Monika Bartekova, Soumaya Ben-Aicha, Timo Brandenburger, David De Gonzalo-Calvo, Costanza Emanueli, Rosienne Farrugia, Johannes Grillari, Matthias Hackl, Barbora Kalocayova, Fabio Martelli, Markus Scholz, Stephanie Bezzina Wettinger, Yvan Devaux, EU-CardioRNA COST Action CA17129

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

15 Citations (Scopus)


Despite significant advances in the diagnosis and treatment of cardiovascular diseases, recent calls have emphasized the unmet need to improve precision-based approaches in cardiovascular disease. Although some studies provide preliminary evidence of the diagnostic and prognostic potential of circulating coding and non-coding RNAs, the complex RNA biology and lack of standardization have hampered the translation of these markers into clinical practice. In this position paper of the CardioRNA COST action CA17129, we provide recommendations to standardize the RNA development process in order to catalyse efforts to investigate novel RNAs for clinical use. We list the unmet clinical needs in cardiovascular disease, such as the identification of high-risk patients with ischaemic heart disease or heart failure who require more intensive therapies. The advantages and pitfalls of the different sample types, including RNAs from plasma, extracellular vesicles, and whole blood, are discussed in the sample matrix, together with their respective analytical methods. The effect of patient demographics and highly prevalent comorbidities, such as metabolic disorders, on the expression of the candidate RNA is presented and should be reported in biomarker studies. We discuss the statistical and regulatory aspects to translate a candidate RNA from a research use only assay to an in-vitro diagnostic test for clinical use. Optimal planning of this development track is required, with input from the researcher, statistician, industry, and regulatory partners.

Original languageEnglish
Pages (from-to)3183-3197
Number of pages15
JournalCardiovascular Research
Issue number16
Early online date14 Oct 2021
Publication statusPublished - 29 Dec 2022


  • Biomarkers
  • Cardiovascular disease
  • Gene expression
  • Genomics
  • Methodology standardization
  • RNAs
  • Transcriptomics
  • Translational cardiovascular research


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