Glucose-insulin-potassium and reperfusion in acute myocardial infarction: rationale and design of the Glucose-Insulin-Potassium Study-2 (GIPS-2).
BACKGROUND
The combination of reperfusion therapy and high-dose glucose-insulin-potassium (GIK) infusion seems beneficial in acute myocardial infarction (MI). Current evidence, however, is not considered conclusive.


METHODS
The Glucose-Insulin-Potassium Study-2 (GIPS-2) will investigate whether GIK, in adjunction to reperfusion therapy, is beneficial in MI patients without signs of heart failure at admission. A total of at least 1044 patients with an acute MI treated with either thrombolysis or primary percutaneous coronary intervention will be randomized to an infusion of high-dose GIK or no infusion. The primary end point of the study is 30-day mortality. Secondary end points are mortality at 1 year, recurrence of MI, repeat intervention, and infarct size.


CONCLUSIONS
If high-dose GIK significantly reduces mortality at 30 days in all patients, the adjunction of this treatment to reperfusion therapy may become part of standard regimen for patients with acute MI without heart failure.
Department of Cardiology, Groningen University Hospital, Groningen, The Netherlands. f.zijlstra@thorax.azg.nl
Iwan C C
IC
van der Horst
Jorik R
JR
Timmer
Jan Paul
JP
Ottervanger
Henk J G
HJ
Bilo
Rijk O B
RO
Gans
Menko-Jan
MJ
de Boer
Felix
F
Zijlstra
D000465:Algorithms; D015906:Angioplasty, Balloon, Coronary; D017209:Apoptosis / Q000187:drug effects; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004562:Electrocardiography; D023381:Endpoint Determination; D004734:Energy Metabolism / Q000187:drug effects; D005230:Fatty Acids, Nonesterified / Q000378:metabolism; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007258:Informed Consent; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control; D009206:Myocardium / Q000378:metabolism; D009426:Netherlands; D018579:Patient Selection; D011188:Potassium / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D012107:Research Design; D018401:Sample Size; D015912:Thrombolytic Therapy
D002317:Cardiovascular Agents; D005230:Fatty Acids, Nonesterified; D007328:Insulin; C030396:glucose-insulin-potassium cardioplegic solution; D005947:Glucose; D011188:Potassium