Targeted drug delivery systems for cardiovascular disease treatment: principles, targeting strategies, and future prospects

BACKGROUND: Targeted drug delivery systems achieve precise drug enrichment at lesion sites through mechanisms such as passive targeting, active targeting, and stimulus-responsive release, offering novel pathways to enhance therapeutic efficacy while reducing systemic toxicity. With advancements in technologies like antibody-drug conjugates and carrier-based encapsulation, these systems have demonstrated remarkable success in treating multiple diseases. DISCUSSION: In the field of cardiovascular diseases (CVD), the large patient population and persistently high mortality rates, coupled with limitations of conventional drugs and surgeries, such as narrow therapeutic windows, insufficient targeting precision, and high invasiveness, make the development of novel targeted delivery strategies crucial for overcoming current therapeutic bottlenecks. Proteins and small molecule drugs are regarded as ideal candidates for targeted delivery due to their high specificity, favorable stability, and tissue penetration capabilities, while delivery carriers such as exosomes and liposomes play a central role in protecting drug activity and guiding targeted accumulation. Furthermore, the appropriate selection of administration routes significantly influences the efficacy of targeted delivery and clinical outcomes. At present, there is still a lack of systematic summaries on the application of targeted drug delivery systems composed of proteins and small molecule drugs in cardiovascular diseases. CONCLUSIONS: This review focuses on targeted drug delivery systems for CVD, to systematically examine the functional properties of carriers designed for proteins and small molecule drugs, as well as the efficacy of different administration routes. It also offers a forward-looking perspective on future trends, aiming to provide theoretical and practical insights for precision medicine.