Atherosclerosis (ATS) and atherothrombosis (ATT) are among the most common cardiovascular diseases (CVDs) worldwide, with their pathological progression involving endothelial dysfunction, recruitment and activation of immune cells, gradual development of plaque, plaque rupture, and subsequent thrombosis. Over the past decade, extracellular vesicles (EVs), lipid bilayer‐enclosed particles, have been shown to play a crucial role in mediating various pathophysiological processes and facilitating intercellular communication, thereby fundamentally contributing to the physiological functions of multicellular organisms. EVs transport biological cargos, including proteins, RNA, DNA, lipids, and metabolites, which can mediate a variety of pleiotropic cellular functions. In this review, we describe EV‐mediated pathological progression of ATS and ATT. Furthermore, we outline the strategies for engineering smart EVs that specifically target componets of ATS or ATT, including injured endothelial cells, lesions, clots, or diseased regions. We also explore innovative EV‐based strategies for delivering therapeutic cargos to achieve enhanced benefits. Finally, we highlight the current challenges and future prospects of EV‐based therapeutics for ATS, ATT, and more broadly for CVDs.
Nguyen et al. (Sun,) studied this question.