The effect of glucose-insulin-potassium treatment on myocardial oxidative stress in patients with acute coronary syndromes undergoing percutaneous coronary intervention.
OBJECTIVE
In this study, we sought to examine the effect of glucose-insulin-potassium (GIK) treatment on oxidative stress in patients with acute coronary syndromes (ACSs) undergoing percutaneous coronary interventions (PCIs).


METHODS
Patients with ACSs who had been electively treated with a stent implantation into the culprit vessel were included in this study. Patients were divided into two groups and were randomly administered either the GIK treatment (GIK group; n=28) or isotonic NaCl (control group; n=19) infusion during PCI. Blood samples from the coronary artery ostium (CO) were collected through the femoral artery and from the coronary sinus (CS) through the femoral vein, before and immediately after PCI. Superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) activities were measured.


RESULTS
A total of 47 patients were included in the study. SOD, CAT, and GSH-Px activities, whether in the CO or the CS, were similar in both the GIK and control groups before the intervention (P>0.05). In the control group, SOD (in both the CO and the CS), CAT (in the CS), and GSH-Px (in the CS) activities were higher compared with baseline values (P<0.05). Such increases were, however, not seen in the GIK group (P>0.05). Although the CS-CO activity differences (venous-arterial) of SOD, CAT, and GSH-Px, which are parameters of myocardial reactive antioxidant enzyme production, were increased in the control group, there was no increase in the GIK group.


CONCLUSIONS
In patients with ACSs, reactive local enzyme activity increases for the scavenging to myocardial-free radicals during PCI. Administration of a solution of GIK as a metabolic support agent might prevent oxidative stress in the myocardial level, in these patients.
Demircan
Sabri
S
Ondokuz Mayis University, Department of Cardiology, Medical Faculty, 55139 - Kurupelit, Samsun, Turkey. sabridemircan@yahoo.com
Yazici
Mustafa
M
Diraman
Emine
E
Demircan
Gunnur
G
Kilicaslan
Fethi
F
Durna
Kenan
K
Acar
Zeydin
Z
Eren
Zafer
Z
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D002314:Cardioplegic Solutions / Q000494:pharmacology*; D002374:Catalase / Q000187:drug effects / Q000378:metabolism; D005260:Female; D005947:Glucose / Q000494:pharmacology; D005979:Glutathione Peroxidase / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000494:pharmacology; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D018384:Oxidative Stress / Q000187:drug effects*; D011188:Potassium / Q000494:pharmacology; D012965:Sodium Chloride / Q000494:pharmacology; D015607:Stents; D013482:Superoxide Dismutase / Q000187:drug effects / Q000378:metabolism
D002314:Cardioplegic Solutions; D007328:Insulin; C030396:glucose-insulin-potassium cardioplegic solution; D019344:Lactic Acid; D012965:Sodium Chloride; D002374:Catalase; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase; D005947:Glucose; D011188:Potassium