Effect of glucose-insulin-potassium (GIK) infusion on biomarkers of cardiovascular risk in ST elevation myocardial infarction (STEMI): insight into the failure of GIK.
Glucose-insulin-potassium (GIK) infusion favourably affects several biomarkers associated with risk in the setting of myocardial infarction (MI). In the context of a recent trial demonstrating no benefit of GIK, we assessed the impact of GIK on inflammation, neurohormonal activation and myonecrosis in ST elevation myocardial infarction (STEMI). In a local substudy of an international randomised trial, 25 patients with STEMI were randomised to receive a 24-hour infusion of GIK vs. no GIK. C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin T (TnT) were assayed at baseline and at 24 hours. The two groups were well matched for baseline characteristics and infarct location. There were no statistically significant differences at baseline or at 24 hours in levels of hs-CRP, NT-proBNP or cTnT, with similar and significant increases in all three biomarkers by 24 hours in both groups. In conclusion, GIK had no discernible effect on biomarkers associated with inflammation, neurohormonal activation or myonecrosis, three pathways associated with adverse outcomes in STEMI.
Parikh
Shailja V
SV
Department of Internal Medicine, the University of Texas Southwestern Medical Center in Dallas, Texas 75235-9047, USA.
Abdullah
Shuaib M
SM
Keeley
Ellen C
EC
Cigarroa
Joaquin E
JE
Addo
Tayo A
TA
Warner
John J
JJ
Khera
Amit
A
de Lemos
James A
JA
McGuire
Darren K
DK
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D004562:Electrocardiography; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011188:Potassium / Q000627:therapeutic use; D013997:Time Factors; D017211:Treatment Failure
D015415:Biomarkers; D007328:Insulin; D010446:Peptide Fragments; C030396:glucose-insulin-potassium cardioplegic solution; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D005947:Glucose; D011188:Potassium