Korean Circ J.  2005 Oct;35(10):779-786. 10.4070/kcj.2005.35.10.779.

Glucose-Insulin-Potassium as an Adjunctive Therapy in Acute Myocardial Infarction

• Kim CM
• Yu KD
• Moon KW
• Paek SH
• Park YG
• Rho TH
• Kim JH
• Choi KB
• Hong SJ

• KMID: 1894586
• DOI: http://doi.org/10.4070/kcj.2005.35.10.779

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.

Keyword

Myocardial infarction; GIK solution; Ventricular remodeling

MeSH Terms

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
Glucose
Insulin
Urokinase-Type Plasminogen Activator