Cardiovascular diseases, particularly myocardial infarction (MI), remain the leading cause of mortality worldwide. The search for novel therapeutic strategies has led to growing interest in green-synthesized nanoparticles as supportive agents in cardiovascular therapy. These biofunctionalized nanoparticles, derived from natural sources such as plants and microbes, offer several advantages, including eco-friendly synthesis, low-cost production, enhanced biocompatibility, improved bioavailability, and reduced toxicity. Nanoparticles target mitochondrial membranes in ischemic cardiomyocytes, where they deliver reactive oxygen species scavengers to alleviate oxidative stress. They have been shown to lower blood pressure, suppress nuclear factor kappa B (NF-κB) signaling, and reduce the expression of pro-inflammatory cytokines such as interleukin-1β (IL-1β) and tumor necrosis factor-alpha (TNF-α). Moreover, we highlight advances in nanoparticle-mediated gene regulation, including the delivery of small interfering RNA (siRNA) to silence key atherogenic targets such as proprotein convertase subtilisin/kexin type 9 (PCSK9) and apolipoprotein B (ApoB). They have demonstrated anti-atherosclerotic activity by reducing foam cell formation in THP-1 monocyte-derived macrophages and inhibiting apoptosis, lipid peroxidation, and production of NADPH-derived superoxides, and stabilizing levels of serum creatine and cardiotropins in myocardial infarcted animals. This review synthesizes current scientific evidence on the clinical relevance and mechanistic pathways of green nanoparticles in cardiovascular medicine, aiming to guide future research and inspire the development of next-generation therapeutics.
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