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Frequency and clinical significance of ischemic preconditioning during percutaneous coronary intervention

^* Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA

View larger version (23K): [in a new window]   Figure 1 (A) (left panel) Histogram depicting the distribution of ST segment shift (mV) during the first inflation in patients manifesting ischemic preconditioning (IP). The median (25th, 75th percentile) values were 10.0 (9.0, 12.0) mV. In all panels, the number of patients is indicated on the y-axis. (Right panel) Histogram depicting the distribution of ST segment shift (mV) during the second inflation in patients manifesting IP. Notice the overall shift to the left of the distribution indicating a significant reduction in the magnitude of ST segment elevation during Inflation 2. The median (25th, 75th percentile) values were 5.0 (4.0, 6.0) mV. (B) (left panel) Histogram depicting a bimodal distribution of ST segment shift (mV) during the first inflation in patients failing to manifest IP. Notice the overall leftward shift compared with A, indicating a reduced extent of ST segment elevation. The median (25th, 75th percentile) ST segment shift was 6.0 (2.0, 8.0) mV. (Right panel) Histogram depicting the distribution of ST segment shift (mV) during the second inflation in patients failing to manifest IP. The distributions are virtually superimposable, indicating no overall change from the first to second inflations. The median (25th, 75th percentile) ST segment shift was 6.0 (2.0, 8.0) mV.

View larger version (12K): [in a new window]   Figure 2 Kaplan-Meier plot of the estimated rates of freedom from death or non-fatal MI during the year after hospital discharge. There was a highly statistically significant reduction in event-free survival (log-rank p = 0.001) in patients failing to manifest ischemic preconditioning (IP) during PCI.