biostudies-literatureUnknown15(1)Zhongxin SAcute myocardial infarction (AMI) is a threat to health, with high morbidity and mortality, posing a challenge to the public health system. This study aimed to explore the efficacy and potential targets of Astragaloside IV (AS-IV) combined with Mesenchymal Stem Cells (MSC)-derived exosomes (Exo) in the treatment of AMI. The effect of AS-IV in treating AMI via MSC exosomes was evaluated by cardiac ultrasound to assess cardiac function, TTC staining to observe myocardial infarction area, TUNEL staining was used to analyze cell apoptosis, and ELISA to measure the IL-6 and TNF-α in myocardial tissue. Proteomics reveals the effect of AS-IV on the protein composition of MSC exosomes. Then, the mechanism of AS-IV improving MI through MSC exosomes was verified based on PDHA1 (pyruvate dehydrogenasScientific reports25461https://www.ebi.ac.uk/biostudies/studies/S-EPMC12259979biostudies-literatureAstragaloside IV increases PDHA1 in mesenchymal stem cell exosomes to treat myocardial infarction.PMC12259979Jinxin HZhang WQin GMZhenqiu YZhongxin SFeng DZhijie CYa ZfalseAstragaloside IV increases PDHA1 in mesenchymal stem cell exosomes to treat myocardial infarction.Acute myocardial infarction (AMI) is a threat to health, with high morbidity and mortality, posing a challenge to the public health system. This study aimed to explore the efficacy and potential targets of Astragaloside IV (AS-IV) combined with Mesenchymal Stem Cells (MSC)-derived exosomes (Exo) in the treatment of AMI. The effect of AS-IV in treating AMI via MSC exosomes was evaluated by cardiac ultrasound to assess cardiac function, TTC staining to observe myocardial infarction area, TUNEL staining was used to analyze cell apoptosis, and ELISA to measure the IL-6 and TNF-α in myocardial tissue. Proteomics reveals the effect of AS-IV on the protein composition of MSC exosomes. Then, the mechanism of AS-IV improving MI through MSC exosomes was verified based on PDHA1 (pyruvate dehydrogenas2025-01-01T00:00:00Z2025 Jul2026-07-15T14:18:29.803Z2026-07-09T10:15:17.33ZS-EPMC122599794065973210.1038/s41598-025-08628-5