| Effects of glucose-insulin-potassium solution on myocardial salvage and left ventricular function after primary angioplasty. | |
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MedLine Citation:
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PMID: 12973173 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the effects of glucose-insulin-potassium (GIK) therapy on infarct size and left ventricular function when used as an adjuvant therapy to primary angioplasty. DESIGN: Prospective, randomized, double-blind, placebo-controlled study. SETTING: Cardiac intensive care unit at a university hospital. PATIENTS: Thirty-seven patients with acute myocardial infarction for whom primary angioplasty was indicated. INTERVENTIONS: Eligible patients were randomized by a blinded pharmacist to GIK solution (30% glucose in water with insulin 50 U/L, and KCl 40 mM/L) vs. placebo at 1.5 mL/kg/hr for 24 hrs. MEASUREMENTS AND MAIN RESULTS: Tc 99m sestamibi myocardial scintigraphy was performed at admission and at 3 months. Primary end points were the changes in left ventricular ejection fraction (LVEF) and the size of salvaged myocardium. Baseline clinical characteristics were similar in both groups. At the 3-month follow-up, a significant overall decrease in infarct size (37 +/- 16% vs. 12 +/- 10%, p <.005) and an increase in LVEF (34 +/- 13% vs. 49 +/- 9%, p =.005) were observed. Patients randomized to GIK solution experienced a significant increase in their LVEF at 3 months (39 +/- 12 to 51 +/- 13, p =.002). Patients who received placebo had no significant differences between baseline and 3-month measurements (44 +/- 13 vs. 49 +/- 14, p = NS). There was a trend toward an increase in myocardial salvage in the GIK group, which did not reach statistical significance. When patients from both groups were compared directly, differences in LVEF improvement were no longer significant. CONCLUSIONS: GIK solution did not improve LVEF or decrease the infarct size among patients undergoing primary angioplasty. |
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Authors:
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Pablo F Castro; Germán Larrain; Ricardo Baeza; Ramón Corbalán; Carolina Nazzal; Douglas P Greig; Fernando P Miranda; Osvaldo Pérez; Mónica Acevedo; Eugenio Marchant; Enrique Olea; Rolando Gonzalez |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 31 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 2003 Aug |
Date Detail:
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Created Date: 2003-09-15 Completed Date: 2003-10-07 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 2152-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiovascular Diseases, Hospital Clínico de la Pontificia Universidad Católica de Chile, Santiago, Chile. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary Cardioplegic Solutions / administration & dosage* Chile Double-Blind Method Female Glucose / administration & dosage* Hospitals, University Humans Infusions, Intravenous Insulin / administration & dosage* Intensive Care Units Male Middle Aged Myocardial Infarction / pathology, radionuclide imaging, therapy* Myocardium Potassium / administration & dosage* Prospective Studies Technetium Tc 99m Sestamibi / diagnostic use Treatment Outcome Ventricular Function, Left |
| Chemical | |
Reg. No./Substance:
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0/Cardioplegic Solutions; 0/glucose-insulin-potassium cardioplegic solution; 109581-73-9/Technetium Tc 99m Sestamibi; 11061-68-0/Insulin; 50-99-7/Glucose; 7440-09-7/Potassium |
| Comments/Corrections | |
Comment In:
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Crit Care Med. 2004 Mar;32(3):906
[PMID:
15090995
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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