Adv Drug Deliv Rev. 2026 Oct 26:115980. doi: 10.1016/j.addr.2026.115980. Online ahead of print.
ABSTRACT
Nanoparticles (NPs) have emerged as versatile platforms for drug delivery in cardiovascular diseases (CVDs), demonstrating robust efficacy in preclinical models by stabilizing atherosclerotic plaques, promoting safe and efficient thrombolysis, and mitigating ischemia-reperfusion injury. These advances highlight the maturation of cardiovascular nanomedicine; however, translation to clinical practice remains limited. This gap between laboratory success and clinical adoption reflects broader challenges in nanomedicine design, including suboptimal delivery to diseased tissues, limited efficacy of single therapeutic payload-based strategies in addressing the multifaceted inflammatory pathways driving CVDs, NPs' immunogenicity, and scale-up feasibility. Addressing these barriers is particularly critical in CVDs, where therapeutic success depends on precise engagement with multiple molecular and cellular drivers of disease. This review discusses the evolving landscape of cardiovascular nanomedicine, focusing on four aspects. First, we highlight advances in NPs bioengineering strategies, such as refined targeting moieties, optimized physicochemical properties, and responsiveness to endogenous and external stimuli that enhance organ- and cell-specific delivery in atherosclerosis, myocardial infarction, and stroke. Second, we discuss analytical innovations that improve characterization and control of NPs' biodistribution, enabling more rational targeting. Third, we evaluate therapeutic payloads, emphasizing how RNA-based and immunomodulatory agents represent a meaningful step toward clinical translation. Fourth, we outline approaches to addressing persistent challenges in safety and scalable manufacturing. Together, these developments establish a foundation for translating NP design principles into practical cardiovascular therapies. With continued progress in targeted delivery, clinical safety, and production scalability, cardiovascular nanomedicine is increasingly well-positioned to translate preclinical advances to transformative patient outcomes.
PMID:42933662 | DOI:10.1016/j.addr.2026.115980