[Therapy with glucose-insulin-potassium reduces the complications in the acute phase of myocardial infarct. Arguments in favor].
Several therapeutic approaches have been proposed for the management of acute myocardial infarction (AMI). In 1961, Sodi-Pallarés presented the Glucose-Insulin-Potassium (GIK) infusion as a valid adjunctive therapy for the treatment of the acute phase. He observed a decrease in mortality which could be explained by some mechanisms such as: arrhythmia prevention, hypoxic cell nutrition, diminution of infarct size and others. Due to the lack of Coronary Care Units at that time, acute myocardial ischemia was considered a high mortality disease. Therefore, the first studies concerning the efficacy of this treatment showed a significant decrease in mortality. After the development of better care and medical attention of AMI patients, and above all after the introduction of fibrinolysis, mortality dramatically diminished. Thus, GIK was considered to give no additional benefit, and its use became restricted to a small number of centers. In this review the physiopathological bases of GIK solution use are given, as well as the results of the main experimental studies and a critical analysis of the scarce clinical studies available. It is concluded that there are enough data to support the use of GIK solution in non-thrombolized AMIs. It could probably also benefit thrombolised ones, although there is no available evidence in this context.
Alegría Ezquerra
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E
Departamento de Cardiología y Cirugía Cardiovascular, Facultad de Medicina, Universidad de Navarra, Pamplona.
Maceria González
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A
D002314:Cardioplegic Solutions / Q000378:metabolism / Q000627:therapeutic use*; D005947:Glucose / Q000378:metabolism / Q000627:therapeutic use; D006801:Humans; D007328:Insulin / Q000378:metabolism / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D009206:Myocardium / Q000378:metabolism; D011188:Potassium / Q000378:metabolism / Q000627:therapeutic use
D002314:Cardioplegic Solutions; D007328:Insulin; C030396:glucose-insulin-potassium cardioplegic solution; D005947:Glucose; D011188:Potassium