Cardiovascular diseases continue to be the leading cause of death in all developed countries.Novel therapeutics for heart attacks, stroke, peripheral arteries disease and thrombosis continue to lag behind dire medical needs.In fact, no significant medicine has been introduced in the past 15-20 years for treatment of hypertension, atherosclerosis, heart failure and myocardial infarction.The lack of innovative medicines in all key cardiovascular diseases represents the Pharmaceutical industry failure to translate breakthrough discoveries into innovative drugs.In this panel review, a Utilitarian discipline of Translational Medicine is presented that outlines the role of biomarkers and translational medicine principles in transformational practices.Specific case studies will be presented that illustrate the importance of observing translational medicine principles and biomarkers in decision making for progressing compound along the discovery, pe-clinical and early clinical development stages.In particular, analysis of case studies in stroke, atherosclerosis and heart failure will be presented.