| Oxidative stress after reperfusion with primary coronary angioplasty: lack of effect of glucose-insulin-potassium infusion. | |
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MedLine Citation:
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PMID: 11889322 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the oxidative stress status and the modification with glucose-insulin-potassium (GIK) therapy in patients with acute myocardial infarction undergoing primary percutaneous transluminal coronary angioplasty. DESIGN: Prospective, randomized, double-blinded, placebo-controlled study. SETTING: Cardiac intensive care unit at the university hospital. PATIENTS: Twenty patients were randomized to GIK solution (30% glucose in water with insulin 50 IU/L, and KCl 40 mM) vs. placebo (normal saline) at 1.5 mL/kg/hr for 24 hrs. The control group was 15 healthy volunteers with no heart disease. INTERVENTIONS: Eligible patients were randomized by a blinded pharmacist, patients with acute myocardial infarction were treated by primary percutaneous transluminal coronary angioplasty and randomized to GIK or placebo (saline solution). Primary angioplasty was successful in nine of ten patients (90%) and ten of ten patients (100%) in the GIK and placebo groups, respectively. Nine (100%) and six (60%) patients from GIK and placebo groups, respectively, underwent stent implantation. MEASUREMENTS AND MAIN RESULTS: We determined plasma levels of lipid peroxidation estimated by the malondialdehyde assay, superoxide dismutase, glutathione peroxidase, and catalase erythrocyte activities at admission and 0.5 and 24 hrs after angioplasty. Baseline determinations were compared with a control group (n = 15). Baseline clinical characteristics and time to treatment (4.5 +/- 3.5 hrs) were similar between groups. Angioplasty success rate (Thrombolysis in Myocardial Infarction [TIMI] 3 flow with residual stenosis < or = 30%) was 90% and 100% in GIK and placebo groups, respectively. Patients with acute myocardial infarction had an increase of malondialdehyde at baseline (2.9 +/- 1.7 vs. 1.1 +/- 0.3 microM, p <.01) and lower enzymatic activities of superoxide dismutase (0.5 +/- 0.5 vs. 1.3 +/- 0.4 U/mg hemoglobin, p <.01) and catalase (147 +/- 73 vs. 198 +/- 31 U/g hemoglobin, p <.01). These measurements did not change significantly after angioplasty and no differences were observed between GIK and placebo groups. CONCLUSION: Patients with acute myocardial infarction had increased levels of oxidative stress associated with a reduction in enzymatic antioxidant reserve. Administration of GIK solution did not improve these abnormalities among patients undergoing primary angioplasty. |
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Authors:
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Guillermo Díaz-Araya; Danniels Nettle; Pablo Castro; Fernando Miranda; Douglas Greig; Ximena Campos; Mario Chiong; Carolina Nazzal; Ramón Corbalán; Sergio Lavandero |
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: 30 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 2002 Feb |
Date Detail:
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Created Date: 2002-03-12 Completed Date: 2002-03-27 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: 417-21 Citation Subset: AIM; IM |
Affiliation:
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Department of Pharmacological and Toxicological Chemistry (GD-A), University of Chile, Santiago. gadiaz@ciq.uchile.cl |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Angioplasty, Transluminal, Percutaneous Coronary* Biological Markers Catalase / drug effects, metabolism Double-Blind Method Female Glucose / pharmacology* Glutathione Peroxidase / drug effects, metabolism Humans Insulin / pharmacology* Male Malondialdehyde / blood Middle Aged Myocardial Infarction / therapy* Oxidative Stress / drug effects* Potassium / pharmacology* Prospective Studies Reperfusion Injury / prevention & control Superoxide Dismutase / drug effects, metabolism |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/glucose-insulin-potassium cardioplegic solution; 11061-68-0/Insulin; 50-99-7/Glucose; 542-78-9/Malondialdehyde; 7440-09-7/Potassium; EC 1.11.1.6/Catalase; EC 1.11.1.9/Glutathione Peroxidase; EC 1.15.1.1/Superoxide Dismutase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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