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While reperfusion remains essential, it does not sufficiently correct immune dysregulation or prevent adverse remodeling. Biomaterials offer a complementary strategy by enabling spatiotemporally controlled immunomodulation and tissue repair. By providing localized delivery of bioactive cues, mechanical support to stabilize the infarct wall, and immuno-instructive interfaces that steer macrophages toward reparative phenotypes, biomaterial platforms can reshape the post-infarction microenvironment. This review summarizes recent biomaterial-mediated strategies for the treatment of coronary heart disease. By integrating advances in immunomodulatory design, controlled drug delivery, and cardiac tissue engineering, it highlights how biomaterials can reshape the post-ischemic microenvironment to improve repair and limit adverse remodeling. These insights not only clarify current opportunities and translational barriers, but also provide guidance for developing next-generation, phase-adaptive and clinically scalable biomaterial platforms.<\/jats:p>","DOI":"10.1007\/s10856-026-07096-1","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:34:55Z","timestamp":1782362095000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Immuno-instructive biomaterials for coronary artery disease and myocardial infarction repair"],"prefix":"10.1007","volume":"37","author":[{"given":"Xuanfu","family":"Chi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaowei","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feifei","family":"Ni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tai","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songsong","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunrui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"7096_CR1","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.jcmg.2024.05.024","volume":"18","author":"D Peeters","year":"2025","unstructured":"Peeters D, Woelders E, Jansen T, Konst R, Crooijmans C, van de Hoef T, et al. 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