Biomarkers and prognosis after myocardial infarction: towards precision cardiology

Cardiovascular diseases remain the leading cause of mortality worldwide, underscoring the urgent need for improved strategies to reduce their global burden. Despite significant advances in the acute management of myocardial infarction (MI) -notably in reducing short-term mortality and extending patient survival- key gaps persist in our understanding of post-infarction pathophysiology and risk stratification. In particular, predicting long-term outcomes and adverse cardiovascular events following MI continues to be a major clinical challenge. This review provides an overview of emerging biomarkers supported by current scientific evidence that show promise in enhancing prognostic assessment after MI. While cardiac troponins and natriuretic peptides remain the standard for diagnosis and initial risk evaluation, novel biomarkers such as galectin-3, lipoprotein(a), receptor for advanced glycation end-products and non-coding RNAs have been associated with increased risk of mortality and major adverse cardiovascular events. A deeper exploration of their biological roles and related signalling pathways may contribute to the identification of new therapeutic targets. In parallel, recent advances in omics technologies, imaging modalities and digital monitoring are enabling more refined phenotypic characterization of post-MI patients, paving the way for personalized management strategies. Altogether, these developments offer a path toward improved prognostication, targeted therapies, and ultimately better clinical outcomes for individuals recovering from MI.