TY - JOUR
T1 - The impact of glucose-insulin-potassium infusion in acute myocardial infarction on infarct size and left ventricular ejection fraction [ISRCTN56720616]
AU - van der Horst, Iwan C. C.
AU - Ottervanger, Jan Paul
AU - van't Hof, Arnoud W. J.
AU - Reiffers, Stoffer
AU - Miedema, Kor
AU - Hoorntje, Jan C. A.
AU - Dambrink, Jan-Henk E.
AU - Gosselink, A. T. Marcel
AU - Nijsten, Maarten W. N.
AU - Suryapranata, Harry
AU - de Boer, Menko-Jan
AU - Zijlstra, Felix
PY - 2005/6/2
Y1 - 2005/6/2
N2 - Background: Favorable clinical outcomes have been observed with glucose-insulin-potassium infusion (GIK) in acute myocardial infarction (MI). The mechanisms of this beneficial effect have not been delineated clearly. GIK has metabolic, anti-inflammatory and profibrinolytic effects and it may preserve the ischemic myocardium. We sought to assess the effect of GIK infusion on infarct size and left ventricular function, as part of a randomized controlled trial.Methods: Patients (n = 940) treated for acute MI by primary percutaneous coronary intervention (PCI) were randomized to GIK infusion or no infusion. Endpoints were the creatinine kinase MB-fraction (CK-MB) and left ventricular ejection fraction (LVEF). CK-MB levels were determined 0, 2, 4, 6, 24, 48, 72 and 96 hours after admission and the LVEF was measured before discharge.Results: There were no differences between the two groups in the time course or magnitude of CK-MB release: the peak CK-MB level was 249 +/- 228 U/L in the GIK group and 240 +/- 200 U/L in the control group (NS). The mean LVEF was 43.7 +/- 11.0 % in the GIK group and 42.4 +/- 11.7% in the control group (P = 0.12). A LVEFConclusion: Treatment with GIK has no effect on myocardial function as determined by LVEF and by the pattern or magnitude of enzyme release. However, left ventricular function was preserved in GIK treated patients.
AB - Background: Favorable clinical outcomes have been observed with glucose-insulin-potassium infusion (GIK) in acute myocardial infarction (MI). The mechanisms of this beneficial effect have not been delineated clearly. GIK has metabolic, anti-inflammatory and profibrinolytic effects and it may preserve the ischemic myocardium. We sought to assess the effect of GIK infusion on infarct size and left ventricular function, as part of a randomized controlled trial.Methods: Patients (n = 940) treated for acute MI by primary percutaneous coronary intervention (PCI) were randomized to GIK infusion or no infusion. Endpoints were the creatinine kinase MB-fraction (CK-MB) and left ventricular ejection fraction (LVEF). CK-MB levels were determined 0, 2, 4, 6, 24, 48, 72 and 96 hours after admission and the LVEF was measured before discharge.Results: There were no differences between the two groups in the time course or magnitude of CK-MB release: the peak CK-MB level was 249 +/- 228 U/L in the GIK group and 240 +/- 200 U/L in the control group (NS). The mean LVEF was 43.7 +/- 11.0 % in the GIK group and 42.4 +/- 11.7% in the control group (P = 0.12). A LVEFConclusion: Treatment with GIK has no effect on myocardial function as determined by LVEF and by the pattern or magnitude of enzyme release. However, left ventricular function was preserved in GIK treated patients.
KW - PRIMARY ANGIOPLASTY
KW - RANDOMIZED-TRIAL
KW - METABOLIC MODULATION
KW - DIABETIC-PATIENTS
KW - OXIDATIVE STRESS
KW - BLOOD-FLOW
KW - REPERFUSION
KW - ISCHEMIA
KW - THERAPY
KW - ECHOCARDIOGRAPHY
U2 - 10.1186/1741-7015-3-9
DO - 10.1186/1741-7015-3-9
M3 - Article
SN - 1741-7015
VL - 3
JO - BMC Medicine
JF - BMC Medicine
M1 - 9
ER -