Ramoni D, Carbone F, Liberale L, Montecucco F. Mothers against decapentaplegic homolog 4 as a proteomic hub in vascular remodeling and residual cardiovascular risk. World J Cardiol 2026; 18(2): 117277 [DOI: 10.4330/wjc.v18.i2.117277]
Corresponding Author of This Article
Fabrizio Montecucco, MD, PhD, Professor, Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, Genoa 16132, Italy. fabrizio.montecucco@unige.it
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Editorial
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 26, 2026 (publication date) through Feb 9, 2026
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Journal Information of This Article
Publication Name
World Journal of Cardiology
ISSN
1949-8462
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Ramoni D, Carbone F, Liberale L, Montecucco F. Mothers against decapentaplegic homolog 4 as a proteomic hub in vascular remodeling and residual cardiovascular risk. World J Cardiol 2026; 18(2): 117277 [DOI: 10.4330/wjc.v18.i2.117277]
Davide Ramoni, Federico Carbone, Luca Liberale, Fabrizio Montecucco, Department of Internal Medicine, University of Genoa, Genoa 16132, Italy
Federico Carbone, Luca Liberale, Fabrizio Montecucco, First Clinic of Internal Medicine, Department of Internal Medicine, Italian Cardiovascular Network, IRCCS Ospedale Policlinico San Martino, Genoa 16132, Italy
Author contributions: Ramoni D wrote the full paper; Liberale L and Carbone F revised the entire work; Montecucco F designed the manuscript; all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fabrizio Montecucco, MD, PhD, Professor, Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, Genoa 16132, Italy. fabrizio.montecucco@unige.it
Received: December 4, 2025 Revised: December 24, 2025 Accepted: January 14, 2026 Published online: February 26, 2026 Processing time: 68 Days and 1.9 Hours
Core Tip
Core Tip: Proteomics is reshaping cardiovascular medicine by revealing network-level molecular mechanisms underlying myocardial infarction and atherothrombosis. Among emerging targets, mothers against decapentaplegic homolog 4 (SMAD4), a central mediator of transforming growth factor-β/bone morphogenetic protein signaling, has gained attention as an interesting regulator linking disturbed flow, inflammation, fibrosis, and vascular remodeling across endothelial and smooth muscle cells. Although not yet supported by large randomized trials, SMAD4 represents a proteomic network hub that may complement established biomarkers such as low-density lipoprotein cholesterol and high-sensitivity C-reactive protein. Integrated within multi-protein signatures and artificial intelligence-based models, SMAD4 may contribute to improved prediction of residual cardiovascular risk and precision phenotyping.
