Discussion
Reperfusion of the ischemic myocardium by PCI reduces the size of infarct and improves left ventricular function. However, in some patients, reperfusion adversely leads to tissue damage, which is known as reperfusion injury [10]. The present study demonstrated that the presence of high TIMI grade before PCI and ischemic preconditioning were the most important variables for myocardial salvage. Furthermore, administration of nicorandil was important in salvaging myocardium in patients with AMI. Stone et al. [17] reported that patients undergoing primary PCI in whom TIMI-3 flow is present before angioplasty have clinical and angiographic evidence of greater myocardial salvage, are less likely to develop complications related to left ventricular failure, and have improved early and late survival. Some studies have shown that prodromal angina pectoris occurring shortly before the onset of infarction is associated with reduced infarct size and improved left ventricular function. Ishihara et al. [18] concluded that prodromal angina has a beneficial effect on long-term prognosis after infarction, suggesting the presence of ischemic preconditioning. Experimental studies have shown that brief episodes of ischemia shortly before prolonged coronary occlusion reduce myocardial infarct size [19].
DiscussionReperfusion of the ischemic myocardium by PCI reduces the size of infarct and improves left ventricular function. However, in some patients, reperfusion adversely leads to tissue damage, which is known as reperfusion injury [10]. The present study demonstrated that the presence of high TIMI grade before PCI and ischemic preconditioning were the most important variables for myocardial salvage. Furthermore, administration of nicorandil was important in salvaging myocardium in patients with AMI. Stone et al. [17] reported that patients undergoing primary PCI in whom TIMI-3 flow is present before angioplasty have clinical and angiographic evidence of greater myocardial salvage, are less likely to develop complications related to left ventricular failure, and have improved early and late survival. Some studies have shown that prodromal angina pectoris occurring shortly before the onset of infarction is associated with reduced infarct size and improved left ventricular function. Ishihara et al. [18] concluded that prodromal angina has a beneficial effect on long-term prognosis after infarction, suggesting the presence of ischemic preconditioning. Experimental studies have shown that brief episodes of ischemia shortly before prolonged coronary occlusion reduce myocardial infarct size [19].
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