Nanomedicine for the molecular diagnosis of cardiovascular pathologies

• Ischemic stroke and myocardial infarction are the main causes of death in the world.
• Their prevalence is related to late detection of high-risk atherosclerotic plaques.
• Biomarkers of atherosclerosis evolution and potential ligands have been identified.
• Nanosystems based on these ligands appear promising for early molecular diagnosis.
• Preclinical and clinical nanosystems for common imaging modalities are described.

Predicting acute clinical events caused by atherosclerotic plaque rupture remains a clinical challenge. Anatomic mapping of the vascular tree provided by standard imaging technologies is not always sufficient for a robust diagnosis. Yet biological mechanisms leading to unstable plaques have been identified and corresponding biomarkers have been described. Nanosystems charged with contrast agents and targeted towards these specific biomarkers have been developed for several types of imaging modalities. The first systems that have reached the clinic are ultrasmall superparamagnetic iron oxides for Magnetic Resonance Imaging. Their potential relies on their passive accumulation by predominant physiological mechanisms in rupture-prone plaques. Active targeting strategies are under development to improve their specificity and set up other types of nanoplatforms. Preclinical results show a huge potential of nanomedicine for cardiovascular diagnosis, as long as the safety of these nanosystems in the body is studied in depth.