The effect of exosome-related therapy in cardiac revascularization procedures: a systematic review.

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

BACKGROUND: Cardiovascular diseases (CVDs) remain the leading global cause of mortality despite advances in revascularization strategies like coronary artery bypass grafting (CABG) and percutaneous interventions. Exosomes have emerged as dual-function agents, acting both as paracrine mediators of vascular repair and as drug-delivery vehicles. This systematic review evaluates the therapeutic efficacy of exosome-based therapies in cardiac revascularization procedures. METHODS: A comprehensive search of Embase, PubMed, Scopus, and Web of Science was conducted from inception to January 2025. We included experimental studies, evaluating animal subjects undergoing revascularizations. Risk of bias was assessed using SYRCLE’s tool. Study characteristics, population characteristics, intervention details, various outcomes, and limitations of each study were extracted from each included study. RESULTS: Eight preclinical studies met our inclusion criteria. We observed that exosome therapies demonstrated significant benefits. Sirolimus-loaded exosomes (SIR-EXO) reduced stenosis to 5% vs. 59% in controls. Exosome-coated stents (ACC-Exo-REDV) suppressed neointimal hyperplasia by 60% compared to bare stents. Brown adipose tissue-derived exosomes increased left ventricular ejection fraction, while CABG + exosome patches restored diastolic function. Exosome-eluting stents reduced pro-inflammator

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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