{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T17:23:27Z","timestamp":1793035407421,"version":"4.5.0"},"reference-count":80,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Coronary artery disease (CAD) remains a leading cause of global morbidity and mortality despite advances in medical and interventional therapies. Mesenchymal stem cell (MSC) therapy has emerged as a promising regenerative approach for patients with refractory or non-revascularizable CAD. MSCs exhibit unique immunomodulatory, pro-angiogenic, and anti-fibrotic properties, primarily through paracrine mechanisms involving the secretion of cytokines, growth factors, and exosomal microRNAs. Clinical and preclinical studies have demonstrated improvements in myocardial perfusion, left ventricular ejection fraction (LVEF), and functional capacity following MSC-based interventions, particularly in patients with low baseline LVEF and heightened inflammation. Various MSC sources\u2014including bone marrow, adipose tissue, and umbilical cord\u2014offer distinct advantages, while delivery strategies such as intracoronary, intramyocardial, intravenous, and subcutaneous administration impact cell retention and efficacy. Advances in genetic modification, hypoxic preconditioning, and exosome-based therapies aim to enhance MSC survival and therapeutic potency. However, challenges persist regarding cell engraftment, cryopreservation effects, and inter-patient variability. Moving toward precision cell therapy, future approaches may involve stratifying patients by inflammatory status, ischemic burden, and comorbidities to optimize treatment outcomes. MSCs may not yet replace conventional therapies but are increasingly positioned to complement them within a personalized, regenerative framework for CAD management.<\/jats:p>","DOI":"10.3390\/ijms26115414","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T05:49:22Z","timestamp":1749102562000},"page":"5414","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Therapeutic Potential and Mechanisms of Mesenchymal Stem Cells in Coronary Artery Disease: Narrative Review"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9433-6493","authenticated-orcid":false,"given":"Tejas","family":"Patel","sequence":"first","affiliation":[{"name":"Apex Heart Institute, Ahmedabad 380059, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Me\u0161i\u0107","sequence":"additional","affiliation":[{"name":"St. Catherine Specialty Hospital, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shai","family":"Meretzki","sequence":"additional","affiliation":[{"name":"Bonus BioGroup, Haifa 31905, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomer","family":"Bronshtein","sequence":"additional","affiliation":[{"name":"Bonus BioGroup, Haifa 31905, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8022-4095","authenticated-orcid":false,"given":"Petar","family":"Brlek","sequence":"additional","affiliation":[{"name":"St. Catherine Specialty Hospital, 10000 Zagreb, Croatia"},{"name":"School of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"Faculty of Science, Department of Molecular Biology, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vered","family":"Kivity","sequence":"additional","affiliation":[{"name":"Bonus BioGroup, Haifa 31905, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7831-0699","authenticated-orcid":false,"given":"Samir B.","family":"Pancholy","sequence":"additional","affiliation":[{"name":"Geisinger Commonwealth School of Medicine, Scranton, PA 18509, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matko","family":"Petrovi\u0107","sequence":"additional","affiliation":[{"name":"St. Catherine Specialty Hospital, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5565-080X","authenticated-orcid":false,"given":"Dragan","family":"Primorac","sequence":"additional","affiliation":[{"name":"St. Catherine Specialty Hospital, 10000 Zagreb, Croatia"},{"name":"School of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"School of Medicine, University of Split, 21000 Split, Croatia"},{"name":"Eberly College of Science, The Pennsylvania State University, State College, University Park, PA 16802, USA"},{"name":"Henry C. Lee College of Criminal Justice and Forensic Sciences, University of New Haven, New Haven, CT 06516, USA"},{"name":"Regiomed Kliniken, 96450 Coburg, Germany"},{"name":"School of Medicine, University of Rijeka, 51000 Rijeka, Croatia"},{"name":"Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"},{"name":"National Forensic Sciences University, Gandhinagar 382007, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"16812","DOI":"10.1002\/jcp.28350","article-title":"A review on coronary artery disease, its risk factors, and therapeutics","volume":"234","author":"Malakar","year":"2019","journal-title":"J. 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