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ST-segment elevation resolution and outcome in patients treated with primary angioplasty and glucose-insulin-potassium infusion.

Abstract：

BACKGROUND:To evaluate the impact of adjunctive high-dose glucose-insulin-potassium (GIK) on ST-segment elevation resolution in patients with ST-segment elevation myocardial infarction (MI). METHODS:As part of a randomized controlled trial of GIK versus no GIK in patients treated with primary percutaneous coronary intervention (PCI) for ST-elevation MI in a tertiary referral center, we analyzed ST-segment elevation resolution. Paired electrocardiographic recordings (baseline and 3 hours after primary PCI) were available in 612 (65%) of 940 patients. RESULTS:We analyzed paired electrocardiograms of 310 patients randomized to GIK and 302 control patients. Baseline characteristics of the groups were comparable. Combined complete (>70%) and partial (30%-70%) resolution was more commonly observed in the GIK group (87%) when compared with the control group (78%), odds ratio 1.92 (95% CI 1.23-3.02, P = .004); 1-year mortality was lower in patients with combined complete and partial resolution compared with patients without resolution (3.8% vs 10.3%, P = .011). There was no difference in 1-year mortality between GIK and control patients (5.5% vs 4.3%, P = .58). CONCLUSIONS:In patients with ST-elevation MI treated with primary PCI, addition of GIK is associated with improved ST-segment elevation resolution. ST-segment elevation resolution is related to improved 1-year survival. No benefit of GIK on 1-year outcome was observed. Future trials should investigate whether GIK-induced improvement of ST-segment elevation resolution results in more favorable clinical outcome.

journal_name

Am Heart J

journal_title

American heart journal

authors

van der Horst IC,De Luca G,Ottervanger JP,de Boer MJ,Hoorntje JC,Suryapranata H,Dambrink JH,Gosselink AT,Zijlstra F,van 't Hof AW

doi

10.1016/j.ahj.2005.03.023

subject

Has Abstract

pub_date

2005-06-01 00:00:00

pages

1135

issue

6

eissn

0002-8703

issn

1097-6744

pii

S0002870305003182

journal_volume

149

pub_type

杂志文章,随机对照试验

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