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Traditional cell therapy has shown equivocal success, shifting the focus to innovative cardioactive biologicals and cell mimetic therapies, particularly extracellular vesicles (EVs). EVs, as carriers of non-coding RNAs and other essential biomolecules, influence neighbouring and remote cell function in a paracrine manner. Compared to cell therapy, EVs possess several clinically advantageous traits, including stability, ease of storage (enabling off-the-shelf clinical readiness), and decreased immunogenicity. Allogeneic EVs from mesenchymal and\/or cardiac stromal progenitor cells demonstrate safety and potential efficacy in preclinical settings. This review delves into the translational potential of EV-based therapeutic approaches, specifically highlighting findings from large-animal studies, and offers a synopsis of ongoing early-stage clinical trials in this domain.<\/jats:p>","DOI":"10.1093\/eurheartj\/ehae089","type":"journal-article","created":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T08:20:32Z","timestamp":1706948432000},"page":"1602-1609","source":"Crossref","is-referenced-by-count":30,"title":["Injury minimization after myocardial infarction: focus on extracellular vesicles"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5827-0439","authenticated-orcid":false,"given":"Lucio","family":"Barile","sequence":"first","affiliation":[{"name":"Cardiovascular Theranostics, Istituto Cardiocentro Ticino, Laboratories for Translational Research , Ente Ospedaliero Cantonale, CH-6500, Bellinzona ,","place":["Switzerland"]},{"name":"Euler Institute, Faculty of Biomedical Sciences, 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