Biomarkers play a crucial role in the preoperative assessment for cardiac surgery, aiding in risk stratification and evaluating comorbid diseases.

This narrative review summarizes current evidence on preoperative biomarkers in cardiac surgery and their role for risk stratification in international guidelines.

A review of relevant literature was conducted to assess the prognostic value of various biomarkers, including their integration into established risk scoring systems.

Among cardiac biomarkers, brain natriuretic peptide (BNP) has been found to independently predict outcomes and may enhance prognostic accuracy when combined with scoring systems such as the Society of Thoracic Surgeons (STS) and Euroscore calculators. Additionally, several biomarkers related to comorbid diseases demonstrate independent associations with postoperative outcomes, some of which are already included in these scoring systems. Biomarkers such as glycosylated haemoglobin, C-reactive protein (CRP), and albumin levels are strongly linked to surgical outcomes and may aid perioperative optimization. Emerging evidence suggests that novel biomarkers, including inflammatory cytokines, may provide predictive value for specific complications.

Biomarkers are an essential component of preoperative assessment and risk stratification in cardiac surgery. Further research is needed to refine biomarker-based predictive models to enhance postoperative morbidity and mortality risk assessment.