Immuno-instructive biomaterials for coronary artery disease and myocardial infarction repair.

Coronary artery disease (CAD) and myocardial infarction (MI) feature a highly dynamic inflammatory milieu. While reperfusion remains essential, it does not sufficiently correct immune dysregulation or prevent adverse remodeling. Biomaterials offer a complementary strategy by enabling spatiotemporally controlled immunomodulation and tissue repair. By providing localized delivery of bioactive cues, mechanical support to stabilize the infarct wall, and immuno-instructive interfaces that steer macrophages toward reparative phenotypes, biomaterial platforms can reshape the post-infarction microenvironment. This review summarizes recent biomaterial-mediated strategies for the treatment of coronary heart disease. By integrating advances in immunomodulatory design, controlled drug delivery, and cardiac tissue engineering, it highlights how biomaterials can reshape the post-ischemic microenvironment to improve repair and limit adverse remodeling. These insights not only clarify current opportunities and translational barriers, but also provide guidance for developing next-generation, phase-adaptive and clinically scalable biomaterial platforms.