Prodromal angina occurring shortly before the onset of infarction, but not previous angina itself, has a beneficial effect on long-term prognosis after infarction, suggesting a relation to ischemic preconditioning.

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Objective-To examine coronary flow reserve immediately after emergency coronary angioplasty in patients with acute myocardial infarction.Design-A 3 F coronary Doppler catheter was used to measure coronary blood flow velocity in the infarct artery and in the non-infarct artery. Maximal hyperaemia was produced by 10 mg of intracoronary papaverine and coronary flow reserve was calculated.Patients-l patients with acute myocardial infarction undergoing both emergency coronary angioplasty (4 7 (3 6) h after the onset of chest pain (mean (SD))) and at follow up catheterisation 16 (4) days after angioplasty.Setting-Hiroshima City Hospital. Patients and methods PATIENTSWe examined coronary flow reserve in 11 patients (10 men and a woman, 53 (14) years (mean (SD))) with acute myocardial infarction undergoing both emergency coronary angioplasty and follow up cardiac catheterisation.Chest pain consistent with ongoing myocardial ischaemia that persisted for > 30 minutes and caused at least 1 mm ST elevation in at least two leads was diagnosed as acute myocardial infarction. Each patient underwent emergency cardiac catheterisation within 12 hours of the onset of symptom (4 7 (3 6) h). Creatine kinase was measured every three hours after hospital admission and peak serum creatine kinase concentration was more than twice of the upper limit of the normal range (3127 (1330) IU/l).

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