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Nanomedicine has emerged as a promising strategy for cardiovascular disease treatment, with synthetic nanoparticles and extracellular vesicles serving as representative delivery platforms. However, directly applying these nanomedicines faces several challenges, including insufficient cardiac targeting, poor retention rate at the injured site, and potential biocompatibility concerns. To overcome these limitations, different bioengineering approaches have been adopted. In this review, we discussed the landscape of cardiovascular nanomedicine, encompassing both synthetic nanocarriers and biological carriers and targeted delivery. We further evaluated the engineering approaches to enhance carrier performance. Multiple administration routes are also compared. Collectively, these advances represent a shift toward an integrated, multifunctional delivery platform with the potential to translate cardiac nanomedicine from bench to bedside.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/atvbaha.126.324247","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:00:52Z","timestamp":1785402052000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Bioengineering Approaches for Nanomedicine Delivery in Therapy of Myocardial Infarction"],"prefix":"10.1161","volume":"46","author":[{"given":"Jiawen","family":"Zou","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering (J.Z., D.Z., X.C., K.C.), Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4645-5786","authenticated-orcid":true,"given":"Dashuai","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering (J.Z., D.Z., X.C., K.C.), Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8487-3412","authenticated-orcid":true,"given":"Xiao","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering (J.Z., D.Z., X.C., K.C.), Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8053-7059","authenticated-orcid":true,"given":"Ke","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering (J.Z., D.Z., X.C., K.C.), Columbia University, New York, NY."},{"name":"Herbert Irving Comprehensive Cancer Center (K.C.), Columbia University, New York, NY."},{"name":"Seymour, Paul and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY (K.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001303"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-025-03221-y"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3791\/52726"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.1164680"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10557-021-07248-1"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41419-020-2542-9"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41434-020-0171-7"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000061911.47710.8a"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0045074"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.020402"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1021\/acsami.1c08044"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2021.686684"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-24804-3"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/adfm.202004377"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bioactmat.2025.08.014"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jconrel.2024.06.023"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41565-019-0591-y"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.adr4333"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1021\/acsnano.2c03060"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/s44222-026-00401-1"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","unstructured":"Cullis PR Hope MJ. 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