A Review on Mechanisms, Design, and Therapeutic Applications of Targeted Nanocarriers in Cardiovascular Conditions

Review Article

Abstract

Cardiovascular diseases are of the leading causes of global morbidity and mortality despite significant advancements in conventional pharmacotherapy. Traditional small-molecule drugs are frequently hampered by unfavorable pharmacokinetic profiles, rapid systemic clearance, poor aqueous solubility, narrow therapeutic indices, and substantial off-target toxicities. Nanocarrier-based drug delivery systems offer targeted, controlled, and site-specific therapeutic interventions that fundamentally transform cardiovascular treatment paradigms. Through tailored physicochemical architectures, nanocarriers including liposomes, polymeric nanoparticles, dendrimers, inorganic nanomaterials, and cell-derived extracellular vesicles bypass physical and physiological barriers to concentrate therapeutic payloads within compromised cardiovascular tissues. Passive accumulation through compromised endothelial permeability, combined with active ligand-mediated targeting against inflammatory cell-surface markers, enhances drug localization at sites of atherosclerosis, myocardial infarction, and vascular restenosis. Stimuli-responsive constructs featuring pH-sensitive polymers, such as poly-L-histidine, and reactive oxygen species-cleavable linkages enable site-specific release triggered by pathological microenvironments. Biomimetic delivery systems such as reconstituted high-density lipoproteins facilitate reverse cholesterol transport and macrophage reprogramming, mitigating atherogenesis. Preclinical and clinical evaluations confirm that nanocarrier encapsulation restores bioactivity, reduces systemic dosage requirements, and attenuates cardiotoxicity associated with potent cardiovascular agents. Addressing manufacturing scalability, long-term biocompatibility, and regulatory standardization will catalyze the translation of nanotherapeutics into routine clinical cardiological practice.