The role of ischemic preconditioning in acute myocardial infarction

Medicinski pregled
Andelka RistićSasa Rafaelovski

Abstract

Ischemic preconditioning is a phenomenon in which brief episodes of ischemia and reperfusion increase myocardial tolerance and substantially reduce the infarction size. Two patients with acute left anterior descending artery occlusion received fibrinolytic therapy within 6 hours of symptom onset, but nevertheless developed myocardial infarctions of different size. The first patient, without a history of preinfarction angina, developed a large anterior infarction, because there was no time for ischemic preconditioning or development of coronary collateral vessels. The second patient, with a 4-day history of preinfarction angina, had a more favorable outcome - he developed apical necrosis, with greater myocardial viability in the infarct-related area. The beneficial effects of angina occurring 24-48h before infarction are resulting from ischemic preconditioning, which reduces cardiac mortality, infarct size and occurrence of life-threatening ventricular arrhythmias.

References

Apr 2, 1998·The New England Journal of Medicine·H ShirakiS Ogawa
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Nov 6, 2001·Journal of the American College of Cardiology·A D KelionA P Banning
Apr 8, 2003·Journal of the American College of Cardiology·Pier D LambiaseMichael S Marber

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