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Ischaemic preconditioning is related to decreasing levels of extracellular adenosine that may be metabolically useful in the at‐risk myocardium: an experimental study in the pig

Aim:  ‘Pre‐treatment’ with short repetitive periods of ischaemia (ischaemic preconditioning) has proved to be a powerful mechanism for modification of the extent of myocardial damage following acute coronary artery occlusion. The exact mechanism of protection induced by ischaemic preconditioning is not known. We herewith put forward a contributing component for protection with preconditioning involving a shift in the adenylate kinase (AK) equilibrium reaction in favour of adenosine triphosphate (ATP) formation.