title: Impact of hypoglycemic agents on myocardial ischemic preconditioning.
abstract: Murry et al in 1986 discovered the intrinsic mechanism of profound protection called ischemic preconditioning. The complex cellular signaling cascades underlying this phenomenon remain controversial and are only partially understood. However, evidence suggests that adenosine, released during the initial ischemic insult, activates a variety of G protein-coupled agonists, such as opioids, bradykinin, and catecholamines, resulting in the activation of protein kinases, especially protein kinase C (PKC). This leads to the translocation of PKC from the cytoplasm to the sarcolemma, where it stimulates the opening of the ATP-sensitive K(+) channel, which confers resistance to ischemia. It is known that a range of different hypoglycemic agents that activate the same signaling cascades at various cellular levels can interfere with protection from ischemic preconditioning. This review examines the effects of several hypoglycemic agents on myocardial ischemic preconditioning in animal studies and clinical trials.
authors.affiliation: Rosa Maria Rahmi Garcia, Paulo Cury Rezende, Whady Hueb, MASS Study Group, Heart Institute of the University of São Paulo, São Paulo 05403-000, Brazil.
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Rahmi Garcia
authors.affiliation: Rosa Maria Rahmi Garcia, Paulo Cury Rezende, Whady Hueb, MASS Study Group, Heart Institute of the University of São Paulo, São Paulo 05403-000, Brazil.
authors.forename: Paulo Cury
authors.initials: PC
authors.lastname: Rezende
authors.affiliation: Rosa Maria Rahmi Garcia, Paulo Cury Rezende, Whady Hueb, MASS Study Group, Heart Institute of the University of São Paulo, São Paulo 05403-000, Brazil.
authors.forename: Whady
authors.initials: W
authors.lastname: Hueb
keywords: Coronary artery disease; Diabetes mellitus; Hypoglycemic agents; Ischemic preconditioning; Myocardial ischemia