PACAP-38 in Acute ST-Segment Elevation Myocardial Infarction in Humans and Pigs: A Translational Study

Int J Mol Sci. 2021 Mar 12;22(6):2883. doi: 10.3390/ijms22062883.


Acute myocardial infarction (MI) is one of the most common causes of death worldwide. Pituitary adenylate cyclase activating polypeptide (PACAP) is a cardioprotective neuropeptide expressing its receptors in the cardiovascular system. The aim of our study was to examine tissue PACAP-38 in a translational porcine MI model and plasma PACAP-38 levels in patients with ST-segment elevation myocardial infarction (STEMI). Significantly lower PACAP-38 levels were detected in the non-ischemic region of the left ventricle (LV) in MI heart compared to the ischemic region of MI-LV and also to the Sham-operated LV in porcine MI model. In STEMI patients, plasma PACAP-38 level was significantly higher before percutaneous coronary intervention (PCI) compared to controls, and decreased after PCI. Significant negative correlation was found between plasma PACAP-38 and troponin levels. Furthermore, a significant effect was revealed between plasma PACAP-38, hypertension and HbA1c levels. This was the first study showing significant changes in cardiac tissue PACAP levels in a porcine MI model and plasma PACAP levels in STEMI patients. These results suggest that PACAP, due to its cardioprotective effects, may play a regulatory role in MI and could be a potential biomarker or drug target in MI.

Keywords: ELISA; STEMI; acute myocardial infarction; cardioprotection; closed-chest myocardial infarction model; pituitary adenylate cyclase activating polypeptide; prognostic factor.

MeSH terms

  • Aged
  • Animals
  • Arrhythmias, Cardiac / blood*
  • Arrhythmias, Cardiac / physiopathology
  • Arrhythmias, Cardiac / surgery
  • Female
  • Glycated Hemoglobin / genetics
  • Heart Ventricles / metabolism
  • Heart Ventricles / pathology
  • Heart Ventricles / surgery
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / blood*
  • Myocardial Infarction / genetics
  • Myocardial Infarction / pathology
  • Myocardial Infarction / surgery
  • Non-ST Elevated Myocardial Infarction / blood
  • Non-ST Elevated Myocardial Infarction / genetics
  • Non-ST Elevated Myocardial Infarction / physiopathology
  • Non-ST Elevated Myocardial Infarction / surgery
  • Percutaneous Coronary Intervention / adverse effects
  • Pituitary Adenylate Cyclase-Activating Polypeptide / blood*
  • Pituitary Adenylate Cyclase-Activating Polypeptide / genetics
  • Risk Factors
  • ST Elevation Myocardial Infarction / blood
  • ST Elevation Myocardial Infarction / genetics*
  • ST Elevation Myocardial Infarction / pathology
  • ST Elevation Myocardial Infarction / surgery
  • Swine
  • Treatment Outcome
  • Troponin / blood


  • Glycated Hemoglobin A
  • Pituitary Adenylate Cyclase-Activating Polypeptide
  • Troponin
  • hemoglobin A1c protein, human