Arrays of highly ordered silicon nanowire (SiNW) clusters are fabricated using complementary metal-oxide semiconductor (CMOS) field effect transistor-compatible technology, and the ultrasensitive, label-free, electrical detection of cardiac biomarker in real time using the array sensor is presented. The successful detection of human cardiac troponin-T (cTnT) has been demonstrated in an assay buffer solution of concentration down to 1 fg/mL, as well as in an undiluted human serum environment of concentration as low as 30 fg/mL. The high specificity, selectivity, and swift response time of the SiNWs to the presence of ultralow concentrations of a target protein in a biological analyte solution, even in the presence of a high total protein concentration, paves the way for the development of a medical diagnostic system for point-of-care application that is able to provide an early and accurate indication of cardiac cellular necrosis.