Atherosclerosis (AS) is a progressive chronic inflammatory disease and the primary cause of global cardiovascular mortality, characterized by lipid deposition, endothelial dysfunction, foam cell formation, and plaque development. Conventional pharmacological interventions suffer from non-specific distribution, low bioavailability, and severe side effects, limiting their clinical efficacy. Rationally designed drug delivery systems (DDSs), including conventional liposomes, polymeric nanoparticles, micelles, dendrimers, hydrogels, and novel biomimetic, nanomotor, and mitochondria-targeted platforms, have emerged as promising strategies. These DDSs enable precise targeting to atherosclerotic plaques, controlled drug release, prolonged circulation time, and enhanced therapeutic efficacy while reducing adverse effects. This review systematically summarizes the classification, design principles, and applications of DDSs in AS treatment, highlighting their potential for optimizing AS diagnosis and therapy.
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