Abstract

We appreciate Dr Madias’ recognition that our recent study1 published in Circulation represents an “advancement in the field of noninvasive cardioprotection for ischemic/reperfusion injury.” We are fully cognizant of the issues that Dr Madias raises, and we agree that interventions applied after the onset of ischemia would be the most clinically relevant because patients with ST-elevation myocardial infarction typically present >30 minutes after the onset of coronary occlusion. Although studies in swine,2 dogs,3 and humans4,5 suggest the efficacy of ischemic postconditioning, Dr Madias points …

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