Document Detail

Cardiac preconditioning during percutaneous coronary interventions.
MedLine Citation:
PMID:  16142599     Owner:  NLM     Status:  MEDLINE    
Ischemic preconditioning (PC) is a polygenic defensive cellular adaptive phenomenon of the heart to ischemic stress, whereby the heart changes its phenotype to become more resistant to subsequent ischemia. Early and late of PC represent two chronologically and pathophysiologically distinct phases of this phenomenon, which can be recruited pharmacologically. We represent a post hoc analysis examining the late PC-mimetic effects of nitroglycerin (NTG) on peri-procedural myocardial necrosis during percutaneous coronary intervention (PCI). A group of 66 patients presenting with angina were randomized, 24 h prior to a scheduled PCI for single obstructive CAD, to a 4 h pretreatment with intravenous NTG or saline. Measurements of electrocardiographic ST-segment shifts, echocardiographic regional wall motion and angina scores demonstrated that NTG pre-treatment preconditioned the heart by rendering it resistant to ischemia during balloon inflations. NTG-pretreated patients exhibited trends towards lower average peak CK (131.1 vs. 188.6 U/L, P = 0.38) and CK-MB levels (7.1 vs. 12.6 ng/ml, P = 0.40). NTG, however, had no significant impact on the incidence of post-procedural MI or any cardiac enzyme elevation. The exploitation of ischemic and pharmacological PC may prove a useful strategy to confer cardioprotection during high-risk PCI and is worth exploring.
Hani Jneid; Massoud Leessar; Roberto Bolli
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy     Volume:  19     ISSN:  0920-3206     ISO Abbreviation:  Cardiovasc Drugs Ther     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-09-05     Completed Date:  2006-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8712220     Medline TA:  Cardiovasc Drugs Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  211-7     Citation Subset:  IM    
Division of Cardiology, the University of Louisville, Louisville, KY 40292, USA.
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MeSH Terms
Adenosine / therapeutic use
Angioplasty, Transluminal, Percutaneous Coronary*
Bradykinin / therapeutic use
Ischemic Preconditioning, Myocardial*
Nicorandil / therapeutic use
Nitroglycerin / therapeutic use
Pravastatin / therapeutic use
Reg. No./Substance:
55-63-0/Nitroglycerin; 58-61-7/Adenosine; 58-82-2/Bradykinin; 65141-46-0/Nicorandil; 81093-37-0/Pravastatin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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