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The role of A₁ adenosine receptors in preconditioning in humans is unknown. To establish whether bamiphylline, a selective antagonist of A₁ adenosine receptors, abolishes ischaemic preconditioning in man, 36 consecutive patients undergoing single-vessel coronary angioplasty were randomized to receive intravenous infusion of bamiphylline (5 mg. kg⁻¹)or placebo (0·9% NaCl) immediately prior to the procedure.

The mean values (±1 SD) of ST segment shifts on the surface and intracoronary electrocardiograms were measured at the end of the first and second balloon inflations, both 2 min long. The severity of cardiac pain was obtained at the same time using a visual analogue scale.

In bamiphylline-treated patients, the mean ST segment shift and the severity of cardiac pain during the second inflation were similar to those …