In atherosclerosis, plaque formation leads to stiffer arteries with increased hypertension. The extracellular matrix composition in atherosclerotic plaques is fragile, and plaque rupture can lead to stroke and myocardial infarctions. Myocardial infarction leads to tissue damage in the heart, which initiates a fibrotic tissue healing process. Understanding this dynamic and rapid extracellular matrix remodeling by assessing the formation and degradation of neo-epitopes can help identify patients at risk of adverse outcomes.

Heart failure affects millions of patients annually and heart failure with preserved ejection fraction is becoming the predominant subtype. Accurately diagnosing and evaluating these patients can be difficult due to high heterogeneity. Cardiac fibrosis is a common trait in heart failure patients.  The extracellular matrix remodeling can be assessed by measuring circulating neo-epitopes of formation and degradation. It is becoming increasingly evident that these specific biomarkers improve both diagnostics and prognostics in patient assessment.