Epigenetic Biomarkers of Cardiovascular Risk in Frail Patients—A Scope Review

Epigenetic biomarkers offer promising potential for early identification and risk stratification of frail individuals susceptible to adverse cardiovascular outcomes. This scope review aimed to identify and evaluate epigenetic biomarkers concurrently associated with frailty and increased cardiovascul...

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Main Authors: Stanisław Wawrzyniak, Julia Cieśla, Magdalena Woś, Ewa Wołoszyn-Horák, Michał M. Masternak, Tomasz Kukulski, Ewa Stępień, Andrzej Tomasik
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Current Issues in Molecular Biology
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Online Access:https://www.mdpi.com/1467-3045/47/6/422
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author Stanisław Wawrzyniak
Julia Cieśla
Magdalena Woś
Ewa Wołoszyn-Horák
Michał M. Masternak
Tomasz Kukulski
Ewa Stępień
Andrzej Tomasik
author_facet Stanisław Wawrzyniak
Julia Cieśla
Magdalena Woś
Ewa Wołoszyn-Horák
Michał M. Masternak
Tomasz Kukulski
Ewa Stępień
Andrzej Tomasik
author_sort Stanisław Wawrzyniak
collection DOAJ
description Epigenetic biomarkers offer promising potential for early identification and risk stratification of frail individuals susceptible to adverse cardiovascular outcomes. This scope review aimed to identify and evaluate epigenetic biomarkers concurrently associated with frailty and increased cardiovascular risk, potentially facilitating more precise patient stratification and treatment decisions. A two-stage literature search was performed using PubMed, Scopus, Web of Science, and Embase databases from the year 2000 through 27 December 2024. Stage 1 identified studies reporting epigenetic biomarkers associated with frailty in blood-derived human samples. Stage 2 assessed cardiovascular relevance by screening the frailty biomarkers identified in Stage 1 for their documented association with cardiovascular diseases. Two independent reviewers conducted screening, data extraction, and risk-of-bias assessments, resolving disagreements via a third reviewer. The primary outcomes were the association of biomarkers with frailty severity and cardiovascular risk. Key epigenetic biomarkers identified included microRNAs (particularly miR-21, miR-146a, miR-451, and miR-92a) and DNA methylation markers (LINE-1 methylation, epigenetic clocks like GrimAge and DunedinPACE, and possibly novel, emerging clocks like DNAmCVDscore and the Smoking Index). Due to specificity limitations, these biomarkers are most promising when used collectively as part of multimarker panels rather than individually. Future research should validate multimarker panels, explore novel biomarkers, and assess clinical integration to optimize precision medicine in frail cardiovascular populations.
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spelling doaj-art-7fa11ef3c8b64a73be7e8a1746c273ea2025-08-20T03:27:10ZengMDPI AGCurrent Issues in Molecular Biology1467-30371467-30452025-06-0147642210.3390/cimb47060422Epigenetic Biomarkers of Cardiovascular Risk in Frail Patients—A Scope ReviewStanisław Wawrzyniak0Julia Cieśla1Magdalena Woś2Ewa Wołoszyn-Horák3Michał M. Masternak4Tomasz Kukulski5Ewa Stępień6Andrzej Tomasik7Doctoral School, Medical University of Silesia, Poniatowskiego 15, 40-055 Katowice, PolandDoctoral School, Medical University of Silesia, Poniatowskiego 15, 40-055 Katowice, PolandDepartment of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752 Katowice, PolandII Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Marii Skłodowskiej-Curie 10, 41-800 Zabrze, PolandDepartment of Biomedical Sciences, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, 6900 Lake Nona Blvd, Orlando, FL 32827, USAII Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Marii Skłodowskiej-Curie 10, 41-800 Zabrze, PolandDepartment of Medical Physics, Marian Smoluchowski Institute of Physics, Jagiellonian University, 30-348 Kraków, PolandII Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Marii Skłodowskiej-Curie 10, 41-800 Zabrze, PolandEpigenetic biomarkers offer promising potential for early identification and risk stratification of frail individuals susceptible to adverse cardiovascular outcomes. This scope review aimed to identify and evaluate epigenetic biomarkers concurrently associated with frailty and increased cardiovascular risk, potentially facilitating more precise patient stratification and treatment decisions. A two-stage literature search was performed using PubMed, Scopus, Web of Science, and Embase databases from the year 2000 through 27 December 2024. Stage 1 identified studies reporting epigenetic biomarkers associated with frailty in blood-derived human samples. Stage 2 assessed cardiovascular relevance by screening the frailty biomarkers identified in Stage 1 for their documented association with cardiovascular diseases. Two independent reviewers conducted screening, data extraction, and risk-of-bias assessments, resolving disagreements via a third reviewer. The primary outcomes were the association of biomarkers with frailty severity and cardiovascular risk. Key epigenetic biomarkers identified included microRNAs (particularly miR-21, miR-146a, miR-451, and miR-92a) and DNA methylation markers (LINE-1 methylation, epigenetic clocks like GrimAge and DunedinPACE, and possibly novel, emerging clocks like DNAmCVDscore and the Smoking Index). Due to specificity limitations, these biomarkers are most promising when used collectively as part of multimarker panels rather than individually. Future research should validate multimarker panels, explore novel biomarkers, and assess clinical integration to optimize precision medicine in frail cardiovascular populations.https://www.mdpi.com/1467-3045/47/6/422frailtyepigenetic biomarkersmicroRNAmethylationepigenetic clockcardiovascular disease
spellingShingle Stanisław Wawrzyniak
Julia Cieśla
Magdalena Woś
Ewa Wołoszyn-Horák
Michał M. Masternak
Tomasz Kukulski
Ewa Stępień
Andrzej Tomasik
Epigenetic Biomarkers of Cardiovascular Risk in Frail Patients—A Scope Review
Current Issues in Molecular Biology
frailty
epigenetic biomarkers
microRNA
methylation
epigenetic clock
cardiovascular disease
title Epigenetic Biomarkers of Cardiovascular Risk in Frail Patients—A Scope Review
title_full Epigenetic Biomarkers of Cardiovascular Risk in Frail Patients—A Scope Review
title_fullStr Epigenetic Biomarkers of Cardiovascular Risk in Frail Patients—A Scope Review
title_full_unstemmed Epigenetic Biomarkers of Cardiovascular Risk in Frail Patients—A Scope Review
title_short Epigenetic Biomarkers of Cardiovascular Risk in Frail Patients—A Scope Review
title_sort epigenetic biomarkers of cardiovascular risk in frail patients a scope review
topic frailty
epigenetic biomarkers
microRNA
methylation
epigenetic clock
cardiovascular disease
url https://www.mdpi.com/1467-3045/47/6/422
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AT ewawołoszynhorak epigeneticbiomarkersofcardiovascularriskinfrailpatientsascopereview
AT michałmmasternak epigeneticbiomarkersofcardiovascularriskinfrailpatientsascopereview
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