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X : Cardiovascular disease is the most frequent cause of death in the western hemisphere. Although significant advances in pharmacotherapy have been achieved, the morbidity and mortality of cardiovascular disease will probably remain a scourge of affluent societies for many years to come. This situation gives the scientific community and the pharmaceutical industry an impetus to develop novel therapeutical strategies. Gene therapy is a principle which may provide new means of targeting the pathophysiological mechanisms of cardiovascular disease and has recently drawn a lot of scientific attention, as the endothelial cells of the vasculature are in direct contact with the blood. Thus, many of the obstacles which are thought to hamper gene delivery may not apply in this system. Although there are many ongoing gene therapy trials in this patient group, the results that have so far been reported are from early phase studies (phase I and II studies) only. The published reports have investigated to what extent the growth factors vascular endothelial growth factor and fibroblast growth factor may improve revascularization in ischaemic myocardial tissue. Although the preliminary results are promising, it should be pointed out that phase III trials have not yet been started in this disease group.

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