Insulin therapy in acute coronary syndromes: an appraisal of completed and ongoing randomised trials with important clinical end points.
Insulin therapy was first proposed as an adjunctive therapy in patients with acute coronary syndromes (ACS) in the 1960s. Since then, numerous randomised clinical trials have been conducted to determine the efficacy and to define the role of insulin therapy in ACS. This review will discuss: 1) completed trials of insulin therapy in ACS, including both glucose-insulin-potassium (GIK) approaches and non-GIK approaches; 2) trials of insulin therapy in critically ill non-ACS patients and the lessons from these trials that can be applied to trials of insulin in ACS patients; and 3) a summary of ongoing and planned trials of insulin in ACS patients.
Goyal
Abhinav
A
Department of Epidemiology, Emory Rollins School of Public Health, Atlanta, GA, USA. agoyal4@sph.emory.edu
Nerenberg
Kara
K
Gerstein
Hertzel C
HC
Umpierrez
Guillermo
G
Wilson
Peter W F
PW
D054058:Acute Coronary Syndrome / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D016638:Critical Illness; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D011188:Potassium / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D016896:Treatment Outcome
D015415:Biomarkers; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; C030396:glucose-insulin-potassium cardioplegic solution; D005947:Glucose; D011188:Potassium