TY - JOUR
T1 - One year outcomes after glucose-insulin-potassium in ST elevation myocardial infarction. The glucose-insulin-potassium study II
AU - Rasoul, Saman
AU - Ottervanger, Jan Paul
AU - Timmer, Jorik R.
AU - Svilaas, Tone
AU - Henriques, Jose P. S.
AU - Dambrink, Jan-Henk E.
AU - van der Horst, Iwan C. C.
AU - Zijlstra, Felix
PY - 2007/10
Y1 - 2007/10
N2 - Background: There are conflicting data concerning the effect of treatment with glucose - insulin - potassium ( GIK) in ST segment elevation myocardial infarction ( STEMI). Early studies showed beneficial effects of GIK, however, recent large sample size trials did not confirm this, or suggested only benefits in patients without heart failure. We aimed to evaluate long- term effects of GIK in patients with STEMI without signs of heart failure, all treated with reperfusion therapy.Methods: From August 2003 to December 2004, 889 STEMI patients without signs of heart failure were randomized to standard care ( N= 445) or additional GIK infusion ( N= 444). Glucose - potassium ( 20% glucose with 80 mmol potassium/ l) was infused at 2 ml/ kg body weight per hour for 12 h through a peripheral line. Short- acting insulin was started according to admission glucose and adjusted based on hourly measured glucose. Clinical end points were of number of death, reinfarction and revascularization at 1 year.Results: One year follow- up was available in 864 patients ( 97.2%), 432 in the GIK group and 432 in the control group. Mortality rate was 5.3% in GIK and 3.9% in control patients, p= 0.33. Rates of reinfarction and revascularization 4.6% vs. 4.6% and 15.5% and 15.0%, in GIK vs. control patients.Conclusion: In patients with STEMI without signs of heart failure treated with reperfusion therapy, GIK therapy offers no clinical benefit at 1 year. (C) 2007 Elsevier Ireland Ltd. All rights reserved.
AB - Background: There are conflicting data concerning the effect of treatment with glucose - insulin - potassium ( GIK) in ST segment elevation myocardial infarction ( STEMI). Early studies showed beneficial effects of GIK, however, recent large sample size trials did not confirm this, or suggested only benefits in patients without heart failure. We aimed to evaluate long- term effects of GIK in patients with STEMI without signs of heart failure, all treated with reperfusion therapy.Methods: From August 2003 to December 2004, 889 STEMI patients without signs of heart failure were randomized to standard care ( N= 445) or additional GIK infusion ( N= 444). Glucose - potassium ( 20% glucose with 80 mmol potassium/ l) was infused at 2 ml/ kg body weight per hour for 12 h through a peripheral line. Short- acting insulin was started according to admission glucose and adjusted based on hourly measured glucose. Clinical end points were of number of death, reinfarction and revascularization at 1 year.Results: One year follow- up was available in 864 patients ( 97.2%), 432 in the GIK group and 432 in the control group. Mortality rate was 5.3% in GIK and 3.9% in control patients, p= 0.33. Rates of reinfarction and revascularization 4.6% vs. 4.6% and 15.5% and 15.0%, in GIK vs. control patients.Conclusion: In patients with STEMI without signs of heart failure treated with reperfusion therapy, GIK therapy offers no clinical benefit at 1 year. (C) 2007 Elsevier Ireland Ltd. All rights reserved.
KW - glucose-insulin-potassium
KW - STEMI
KW - long-term outcome
KW - ACUTE CORONARY SYNDROMES
KW - DIABETES-MELLITUS
KW - RANDOMIZED-TRIAL
KW - MORTALITY
KW - INFUSION
KW - ASSOCIATION
KW - THERAPY
KW - RISK
U2 - 10.1016/j.ijcard.2006.11.037
DO - 10.1016/j.ijcard.2006.11.037
M3 - Article
SN - 0167-5273
VL - 122
SP - 52
EP - 55
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 1
ER -