Discussion

Coronary artery disease (CAD) is the leading cause of morbidity and mortality in developed countries and is responsible for 1 in 6 deaths in the United States. CAD imposes a tremendous toll, not only on the lives of individual patients, but also upon the healthcare systems of every nation in the western world. Current treatment options include medical beta-blockers, ACE inhibitors and angiotensin II receptor blockers (ARBs) and in some cases heart transplant. While current drugs are effective in slowing the progression of heart failure, their off-target effects at higher doses limit their clinical utility. Notably, hypertension poses a serious threat in both diabetic and non-diabetic heart failure patients with reduced cardiac function and effectively limits the dose that can be administered long-term. It can therefore be argued that new therapeutic strategies are desperately needed to improve the therapeutic index, not only for the existing active pharmaceutical ingredients (API) used to treat heart failure, but also for more novel strategies such as cardiac regeneration. To address the limitations associated with systemic drug-delivery, we have identified peptides specific for the diseased heart, and are able to direct the peptide targeted, drug-loaded liposomes to important cell populations in the remodeling heart.