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(Circulation. 2005;112:1241.)
© 2005 American Heart Association, Inc.

Issue Highlights

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	INTERRUPTIONS OF CHEST COMPRESSIONS DURING EMERGENCY MEDICAL SYSTEMS RESUSCITATION, by Valenzuela et al.

 
Survival to hospital discharge from out-of-hospital cardiac arrest remains poor. Although there are many possible reasons for this, efforts to uncover and address each factor may subsequently lead to improved outcomes. In this issue of Circulation, Valenzuela and colleagues evaluate whether frequent interruptions of chest compression during the resuscitation period may contribute to low survival rates. In an analysis of automated external defibrillator–equipped fire department first responders, the authors investigate the precise timing of the delivery of automated external defibrillator shock from the 9-1-1 call and the percentage of time that chest compressions were performed during 61 cardiac arrests. Their surprising findings highlight the need for a greater focus on cardiopulmonary resuscitation performance as part of the resuscitation effort. See p 1259.

	IMPACT OF A SINGLE INTRAVENOUS ADMINISTRATION OF NICORANDIL BEFORE REPERFUSION IN PATIENTS WITH ST-SEGMENT–ELEVATION MYOCARDIAL INFARCTION, by Ishii et al.

 
Nicolandil is a hybrid between nitrates and KATP channel opener. Nicolandil has venodilating properties due to nitrate group in its chemical structure and causes smooth muscle relaxation and subsequent vasodilation by increasing potassium flux through sarcolemma ATP-sensitive potassium channels. Therefore, the drug acts as a balanced arterial dilator and venodilator. Unlike classical nitrates, hemodynamic tolerance to nicolandil has been reported to be negligible. The potassium channel activation also exerts direct cardioprotective effects by activating ectosolic 5’-nucleotide and mimicking ischemic preconditioning. Infarct-limiting effects of nicolandil have been shown in a number of animal models. Nicolandil has been studied extensively in many patients with ischemic heart disease, both in placebo-controlled studies and in comparative studies with other antiischemic agents. Efficacy of intravenous nicolandil in conjunction with coronary angioplasty . . . [Full Text of this Article]

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