As opposed to the HUVEC proliferation mechanism, one study found that adipocyte MSC-exos have a profound effect on endothelial progenitor cells (EPCs) in patients suffering acute myocardial infarction, as exosomes overexpressing sirtuin-1 (SIRT1) caused increased expressions of CXC chemokine-12 (CXCL12) and nuclear factor E2 related factor 2 (Nrf2) in those EPCs. This evidence concerns the gene SIRT1 and acute myocardial infarction.