The availability of highly sensitive troponin assays (hsTn) allows the safe clinical application of international recommendations and the introduction of fast-track protocols for the definition of AMI. However, hsTn assays have not always been welcomed by clinicians, claiming an increase in false-positive results. To guide interpretation of results, laboratory specialists need to get involved in communicating with clinicians through education, test interpretation and internal audits of test usage and patient outcomes. Since natriuretic peptides were successfully integrated into the clinical practice of heart failure (HF), the possibility of using new biomarkers to advance the management of affected patients has been explored. However, very few have made the difficult translation from initial promise to clinical application. These markers mirror the complex pathophysiology of HF: fibrosis (ST2 and galectin-3), infection (procalcitonin), and renal disease (renal markers). Traditional predictors suboptimally predict cardiovascular disease in individuals with chronic kidney disease (CKD). Recent studies propose new cardiac and kidney markers for the improvement of cardiovascular prediction among those subjects with CKD.