Clinical effects of ischemic preconditioning

A variety of experimental studies have confirmed that preconditioning the m yocardium by brief periods of ischemia represents a powerful cardioprotecti ve effect resulting in a reduction of infarct size. After 15 years of resea rch in the experimental laboratory, some evidence shows the existence of pr econditioning in human patients with coronary artery disease: repeated ball oon inflations before coronary angioplasty induce preconditioning-like effe cts; moreover, some studies demonstrate better clinical outcome in patients with angina before acute myocardial infarction, resembling a preconditioni ng effect. So far, a few drugs have been identified as potential mediators of preconditioning, eg, adenosine, adenosine receptor agonists, and adenosi ne triphosphate-sensitive potassium channel openers. Before coronary angiop lasty and heart surgery, these preconditioning mimetics might be used to pr otect myocardial tissue by means of preconditioning; Further research is re quired before preconditioning mimetics could be used for therapy in patient s with chronic myocardial ischemia. Possible antipreconditioning effects of several drugs, eg, sulfonylurea drugs have to be considered in the treatme nt of patients with coronary artery disease. Curr Opin Cardiol 1999, 14:340 -348 (C) 1999 Lippincott Williams & Wilkins, Inc.