title: Ischemic preconditioning-an unfulfilled promise.
abstract: Myocardial reperfusion injury has been identified as a key determinant of myocardial infarct size in patients undergoing percutaneous or surgical interventions. Although the molecular mechanisms underpinning reperfusion injury have been elucidated, attempts at translating this understanding into clinical benefit for patients undergoing cardiac interventions have produced mixed results. Ischemic conditioning has been applied before, during, or after an ischemic insult to the myocardium and has taken the form of local induction of ischemia or ischemia of distant tissues. Clinical studies have confirmed the safety of differing conditioning techniques, but the benefit of such techniques in reducing hard clinical event rates has produced mixed results. The aim of this article is to review the role of ischemic conditioning in patients undergoing percutaneous and surgical coronary revascularization.
authors: Ashford & St. Peter's Hospitals NHS Foundation Trust, Guildford Road, Surrey, KT16 0PZ, United Kingdom.
authors: Timothy M
authors: TM
authors: Williams
authors: Washington Hospital Centre, 110 Irving Street, Washington, DC 20010, USA.
authors: Ron
authors: R
authors: Waksman
authors: Ashford & St. Peter's Hospitals NHS Foundation Trust, Guildford Road, Surrey, KT16 0PZ, United Kingdom.
authors: Kalpa
authors: K
authors: De Silva
authors: Ashford & St. Peter's Hospitals NHS Foundation Trust, Guildford Road, Surrey, KT16 0PZ, United Kingdom.
authors: Adam
authors: A
authors: Jacques
authors: Ashford & St. Peter's Hospitals NHS Foundation Trust, Guildford Road, Surrey, KT16 0PZ, United Kingdom; University of Surrey, 13AY04, Surrey, GU2 7XH, United Kingdom. Electronic address: m.mahmoudi@surrey.ac.uk.
authors: Michael
authors: M
authors: Mahmoudi
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000009:adverse effects / Q000379:methods*; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D020380:Needs Assessment; D061214:Patient Safety; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Cardiac surgery; Ischemic preconditioning; Percutaneous coronary intervention