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document
Effects of glucose-insulin-potassium infusion on ST-elevation myocardial infarction in patients treated with thrombolytic therapy . The role of glucose-insulin-potassium ( GIK ) infusion in the management of acute myocardial infarction is not well established . This prospective , randomized study comprised 120 patients who had ST-elevation myocardial infarction that was treated within 12 hours from symptom onset with a high dose of GIK ( 25 % glucose , 50 IU of soluble insulin per liter , and 80 mmol of potassium chloride per liter at 1 ml/kg/hour over 24 hours ) as adjunct to thrombolytic therapy ( 1.5 MU of streptokinase/30 to 60 minutes ; GIK group ) or thrombolytic therapy alone ( control group ) . The primary end point of the study was the rate of major adverse cardiac events ( MACEs ) at 1 month , defined as a composite of cardiac death , reinfarction , serious arrhythmias ( ventricular fibrillation and/or tachycardia ) , and severe heart failure . The secondary end points were the rate of MACEs at 1 year and improvement in left ventricular systolic function . The incidence of MACEs at 1 month was significantly lower in the GIK group ( 10 % vs 32.5 % , relative risk 0.24 , 95 % confidence interval 0.09 to 0.63 , p = 0.0043 ) . Patients in the GIK group had significant decreases in ventricular tachycardia and/or fibrillation ( 1.3 % vs 15.0 % , p = 0.003 ) and severe heart failure ( 3 % vs 12.5 % , p = 0.031 ) . The rate of MACEs at 1 year was also significantly lower in the GIK group ( 13 % vs 40.0 % , relative risk 0.22 , 95 % confidence interval 0.09 to 0.55 , p = 0.0012 ) . After 1 year , there was a significant improvement in left ventricular ejection fraction in the GIK group ( from 48 +/- 8 % to 51 +/- 10 % , p < 0.01 ) , which was not observed in the control group . In conclusion , high-dose GIK , used as an adjunct to thrombolytic therapy , was safe and improved clinical outcome at 1 month . The beneficial effect of GIK infusion was maintained up to 1 year .
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Intervention_Pharmacological
glucose-insulin-potassium infusion
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Intervention_Pharmacological
glucose-insulin-potassium ( GIK ) infusion
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Intervention_Pharmacological
GIK ( 25 % glucose , 50 IU of soluble insulin per liter , and 80 mmol of potassium chloride per liter at 1 ml/kg/hour over 24 hours ) as adjunct to thrombolytic therapy ( 1.5 MU of streptokinase/30 to 60 minutes ; GIK group
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Intervention_Control
thrombolytic therapy alone ( control group ) .
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Intervention_Pharmacological
GIK group
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Intervention_Pharmacological
GIK
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Intervention_Pharmacological
GIK group
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Intervention_Pharmacological
GIK group
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Intervention_Control
control
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Intervention_Pharmacological
GIK
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Intervention_Pharmacological
GIK
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Outcome_Physical
ST-elevation myocardial infarction
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Outcome_Physical
acute myocardial infarction
23953
Outcome_Physical
rate of major adverse cardiac events ( MACEs ) at 1 month
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Outcome_Physical
a composite of cardiac death , reinfarction , serious arrhythmias ( ventricular fibrillation and/or tachycardia ) , and severe heart failure
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Outcome_Physical
rate of MACEs at 1 year
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Outcome_Physical
left ventricular systolic function
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Outcome_Physical
incidence of MACEs at 1 month
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Outcome_Physical
ventricular tachycardia and/or fibrillation
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Outcome_Physical
heart failure
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Outcome_Physical
rate of MACEs at 1 year
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Outcome_Physical
left ventricular ejection fraction
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Outcome_Other
safe
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Outcome_Physical
clinical outcome
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Participant_Condition
ST-elevation myocardial infarction
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Participant_Condition
ST-elevation myocardial infarction