Activation of cellular preconditioning. Human bone marrow derived stem (hBMDSC) have been shown to have remarkable therapeutic potential in vitro and in vivo. The mechanism of the therapeutic benefits must be multifaceted, involves enhanced expression, and release of trophic/growth factors that provide autocrine and paracrine modulation and protection on the adult human myocardium and stimulation of the endogenous regenerative responses. However, when this class of cells are exposed into an ischemic environment, revealed reduced survival rates and impaired angiogenic capacity. Exposure to sub-lethal hypoxia might impair the intracellular signaling pathways involved in regenerative processes and may not provide a resource of several trophic agents and growth factors that might play important role in cell survival, angiogenesis, and differentiation of hBMDSC. Recently, in animal model of myocardial infarction, P2Y12 blocker cangrelor was shown to be a potent cardioprotective modulator through mobilization of progenitor cells and protective signaling on myocytes and smooth muscle cells rather than any effect on platelet aggregation.