ST-segment elevation resolution and outcome in patients treated with primary angioplasty and glucose-insulin-potassium infusion - 21/08/11
, Giuseppe De Luca, MD, PhD b, Jan Paul Ottervanger, MD, PhD b, Menko-Jan de Boer, MD, PhD b, Jan C.A. Hoorntje, MD, PhD b, Harry Suryapranata, MD, PhD b, Jan-Henk E. Dambrink, MD, PhD b, A.T. Marcel Gosselink, MD, PhD b, Felix Zijlstra, MD, PhD a, Arnoud W.J. van 't Hof, MD, PhD bRésumé |
Background |
To evaluate the impact of adjunctive high-dose glucose-insulin-potassium (GIK) on ST-segment elevation resolution in patients with ST-segment elevation myocardial infarction (MI).
Methods |
As part of a randomized controlled trial of GIK versus no GIK in patients treated with primary percutaneous coronary intervention (PCI) for ST-elevation MI in a tertiary referral center, we analyzed ST-segment elevation resolution. Paired electrocardiographic recordings (baseline and 3 hours after primary PCI) were available in 612 (65%) of 940 patients.
Results |
We analyzed paired electrocardiograms of 310 patients randomized to GIK and 302 control patients. Baseline characteristics of the groups were comparable. Combined complete (>70%) and partial (30%-70%) resolution was more commonly observed in the GIK group (87%) when compared with the control group (78%), odds ratio 1.92 (95% CI 1.23-3.02, P = .004); 1-year mortality was lower in patients with combined complete and partial resolution compared with patients without resolution (3.8% vs 10.3%, P = .011). There was no difference in 1-year mortality between GIK and control patients (5.5% vs 4.3%, P = .58).
Conclusions |
In patients with ST-elevation MI treated with primary PCI, addition of GIK is associated with improved ST-segment elevation resolution. ST-segment elevation resolution is related to improved 1-year survival. No benefit of GIK on 1-year outcome was observed. Future trials should investigate whether GIK-induced improvement of ST-segment elevation resolution results in more favorable clinical outcome.
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| This study was supported by a grant from the Netherlands Heart Foundation (99.028). Presented in part at the meeting of the European Society of Cardiology, Vienna, September 2003. |
Vol 149 - N° 6
P. 1135.e1-1135.e9 - juin 2005 Retour au numéro
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