Glucose-Insulin-Potassium as an Adjunctive Therapy in Acute Myocardial Infarction.
10.4070/kcj.2005.35.10.779
- Author:
Chul Min KIM
1
;
Ki Dong YU
;
Kun Woong MOON
;
Sang Hong PAEK
;
Yong Gyu PARK
;
Tae Ho RHO
;
Jae Hyung KIM
;
Kyu Bo CHOI
;
Soon Jo HONG
Author Information
1. Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. cmkim@vincent.cuk.ac.kr
- Publication Type:Clinical Trial ; Original Article
- Keywords:
Myocardial infarction;
GIK solution;
Ventricular remodeling
- MeSH:
Echocardiography;
Energy Metabolism;
Follow-Up Studies;
Glucose;
Heart Failure;
Humans;
Insulin;
Myocardial Infarction*;
Phlebitis;
Prospective Studies;
Random Allocation;
Thrombolytic Therapy;
Urokinase-Type Plasminogen Activator;
Ventricular Remodeling
- From:Korean Circulation Journal
2005;35(10):779-786
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Glucose-insulin-potassium (GIK) fluid infusion may improve the myocardial energy metabolism in the ischemic condition. A prospective randomized clinical trial was designed to determine whether a GIK fluid infusion can reduce the ventricular remodeling in acute myocardial infarction. SUBJECTS AND METHODS: For the patients with acute myocardial infarction, during thrombolytic therapy with urokinase, GIK fluid (26% glucose 1000 mL, 50 IU insulin, and 80 mmol KCl) was administered for 24 hours. The ventricular volumes and function were evaluated by echocardiography during the admission period, at 6 months and at 12 months following discharge. RESULTS: This trial was done prospectively for 2 years in 73 patients; the GIK group included 41 patients and the control group included 32 patients. The median value of "the pain to door time" was 195 minutes in the GIK group and it was 120 minutes in the control group (p=NS). The wall motion score was 1.52+/-0.39 in the GIK group and it was 1.39+/-0.35 in the control group. The left ventricular volumes, ejection fractions, cardiac indices and the globular indices showed no significant difference between the two groups. The side effects of the GIK fluid were mild phlebitis in 6 patients (14.6%) and congestive heart failure in 5 patients (12.2%). CONCLUSION: This trial could not verify the beneficial effects of administering GIK fluid on the ventricular remodeling after acute myocardial infarction. The limitations of this trial were as follows: "the pain to door time" was too long and the severity of the myocardial infarction was mild. Low rates for the echocardiogrphy follow-up and the randomization failure in a few patients were also noted.
