title: C-Reactive protein reactions to glucose-insulin-potassium infusion and relations to infarct size in patients with acute coronary syndromes.
abstract: BACKGROUND
  Some benefits of glucose-insulin-potassium (GIK) in patients with acute coronary syndromes (ACS) may be from an anti-inflammatory effect. The primary aim of this study was to assess the impact of GIK administration early in the course of ACS on inflammatory marker C-reactive protein (CRP) levels. A secondary aim was to investigate the association between CRP and 30-day infarct size.
  
  
  RESULTS
  Retrospective analysis of participants with ACS randomly assigned to GIK or placebo for at least 8 h in the IMMEDIATE Trial biological mechanism cohort (n = 143). High sensitivity CRP (hs-CRP) was measured at emergency department presentation, and 6 and 12 h into infusion. Logarithmically transformed hs-CRP values at 12-hours were lower with GIK vs. placebo (mean =0.65 mg/L in GIK, 0.84 mg/L in placebo), with a marginal trend toward significance (P = 0.053). Furthermore, using mixed models of hs-CRP, time, and study group, there was a significant increase in hs-CRP levels over time, but the rate of change did not differ between treatment arms (P = 0.3). Multivariable analysis showed that an elevation in hs-CRP, measured at 12 h, was an independent predictor of 30-day infarct size (β coefficient, 6.80; P = 0.04) using sestamibi SPECT imaging.
  
  
  CONCLUSIONS
  The results of this study show no significant effect of GIK on hs-CRP. In addition our results show that in patients with ACS, hs-CRP measured as early as 12 h can predict 30-day infarct size.
authors.affiliation: Clinical and Translational Science Graduate Program, Sackler School of Biomedical Sciences, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA.|Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Hadeel
authors.initials: H
authors.lastname: Alkofide
authors.affiliation: MCRI Center for Translational Genomics, Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, USA.
authors.forename: Gordon S
authors.initials: GS
authors.lastname: Huggins
authors.affiliation: Center for Cardiovascular Health Services Research, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.|Regulatory and Clinical Research Management, Department of Health Sciences, Regis College, Weston, MA, USA.
authors.forename: Joni R
authors.initials: JR
authors.lastname: Beshansky
authors.affiliation: Center for Cardiovascular Health Services Research, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.|Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Ruthazer
authors.affiliation: Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Inga
authors.initials: I
authors.lastname: Peter
authors.affiliation: Clinical and Translational Science Graduate Program, Sackler School of Biomedical Sciences, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA.
authors.forename: Madhab
authors.initials: M
authors.lastname: Ray
authors.affiliation: Clinical and Translational Science Graduate Program, Sackler School of Biomedical Sciences, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA.|Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA.
authors.forename: Jayanta T
authors.initials: JT
authors.lastname: Mukherjee
authors.affiliation: Center for Cardiovascular Health Services Research, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA. hselker@tuftsmedicalcenter.org.|Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA. hselker@tuftsmedicalcenter.org.
authors.forename: Harry P
authors.initials: HP
authors.lastname: Selker
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000188:drug therapy*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002314:Cardioplegic Solutions / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy; D011188:Potassium / Q000008:administration & dosage; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D015415:Biomarkers; D002314:Cardioplegic Solutions; D007328:Insulin; C030396:glucose-insulin-potassium cardioplegic solution; D002097:C-Reactive Protein; D005947:Glucose; D011188:Potassium