Potassium, Glucose, and Insulin in Myocardial Infarction

Pilcher, J. D.; Etishamudin, M.; Exon, P.D.; Moore, John W.

doi:10.1016/s0140-6736(67)92691-8

Cited by 22 publications

(6 citation statements)

References 2 publications

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“…First, the initial promising GIK studies were small and were done in the era before reperfusion therapy (thrombolytics or angioplasty) and other modern therapies for myocardial infarction, and their relevance in today's practice is unclear. Indeed, in further subgroup analysis, we found that the use of GIK during myocardial infarction in the prereperfusion era [22][23][24][25][26][27][28][29][30][31][32][33]35,37,38,41 provided a marginally significant benefit (RR, 0.84; 95% CI, 0.71-1.00), but we did not appreciate any benefit of insulin use when we combined data from studies that used thrombolytics or angioplasty (RR, 1.02; 95% CI, 0.75-1.39). 15,17,19,45,46,50 Therefore, it appears that the potential benefit of GIK infusion for myocardial infarction is attenuated with concomitant use of reperfusion therapy.…”

Section: Methods Of Insulin Administration Gik Vs Non-gikmentioning

confidence: 80%

“…15,17,19,45,46,50 Therefore, it appears that the potential benefit of GIK infusion for myocardial infarction is attenuated with concomitant use of reperfusion therapy. However, GIK infusion may still have in important role in the period before reper- 15,17,19,20,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]42,[44][45][46][47][49][50][51]53 32 26234 9.98 0.96 (0.89-1.03) GIK in AMI 15,17,19,[22][23][24][25][26][27][28][29][30]…”

Section: Methods Of Insulin Administration Gik Vs Non-gikmentioning

confidence: 99%

See 1 more Smart Citation

Insulin Therapy and In‐Hospital Mortality in Critically Ill Patients: Systematic Review and Meta‐analysis of Randomized Controlled Trials

Pittas

Siegel

Lau

2006

J Parenter Enteral Nutr

151

111

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Section: Methods Of Insulin Administration Gik Vs Non-gikmentioning

confidence: 80%

Section: Methods Of Insulin Administration Gik Vs Non-gikmentioning

confidence: 99%

Insulin Therapy and In‐Hospital Mortality in Critically Ill Patients: Systematic Review and Meta‐analysis of Randomized Controlled Trials

Pittas

Siegel

Lau

2006

J Parenter Enteral Nutr

151

111

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“…The clinical experience of Sodi-Pollares shows this therapy to increase the probability of survival after myocardial infarction [59], However, this study does not involve a concurrent control group -a criticism which also can be levelled against studies by Fritz [16] and Kernohan [25]. Other workers also have not obtained a reduction in mortality with this polarizing solution [13,32,33,46,56], though a few have noted a non-significant reduction in mortality [44,47] or in the fre quency of arrhythmia [31]. The sole important study confirming SodiPollares' experience is that of Mittra [36] and the promoter of this method has since replied that the various authors cited did not follow closely his therapeutic recommendations [58],…”

Section: The So-called 'Polarizing' Solutionsmentioning

confidence: 91%

The Difficulty of Appraisal of Streptokinase Treatment of Myocardial Infarction

Verstraete¹

1971

J Vasc Res

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Considerable advances have been made in clinical pharmacology of late, permitting more precise evaluation of new drugs. This must be taken into account in assessing the thrombolytic therapy of acute myocardial infarction. Clinical trials necessitate control groups, which must in volve a sufficiently large number of patients so that differences are not due to chance. To be valid, the groups must be strictly comparable. It is essential to define precisely criteria for admission and contraindications, if possible stratifying the patients, since the final evaluation must include all patients according to the treatment originally allocated. For recent myocardial infarction, it is important to compare thrombolytic therapy with the best treatment currently available, the patients being randomly allocated to these alternatives. However, it is not clear whether the best current treatment is anticoagulation, polarizing solutions (combining glucose, insulin and potassium), prophylactic antiarrhythmic drugs (procainamide, lignocaine) or <i>β</i>-adrenergic inhibitors (propranolol), and therefore which to use in comparison. The trend to coronary care units already has shown a reduction in mortality, perhaps necessitating evaluation of thrombolytic therapy only in such units. If thrombolysis finds a place in the management of myocardial infarction, treatment must start within the first hours following onset of symptoms. This increases the likelihood that patients diagnosed erroneously also will be treated with thrombolytic agents. Reassurance is needed that such treatment is harmless in these circumstances. Lastly, the statistical interpretation of the value of thrombolytic therapy must be regarded as a ‘two-tailed’ situation.

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“…[29][30][31][32][33][34][35][36][37] Fath-Ordoubadi and Beatt performed a meta-analysis of these studies, leaving out studies without a proper design. [29][30][31][32][33][34][35][36][37] Fath-Ordoubadi and Beatt performed a meta-analysis of these studies, leaving out studies without a proper design.…”

Section: In Vitro Studiesmentioning

confidence: 99%

The effect of insulin on the heart

Klein

Visser²

2010

NHJL

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Insulin infusion has been advocated in the treatment of myocardial ischaemia and myocardial infarction. There is evidence from experimental animal studies for a protective effect of high-dose insulin administration in myocardial ischaemia and myocardial infarction. In some relatively small study populations a reduction in mortality was reported in those patients who received glucose-insulin-potassium (GIK) during myocardial infarction, which was confirmed in two meta-analyses. However, it has not been possible to reproduce these positive results in large randomised clinical trials. (Neth Heart J 2010;18:255-9.).

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Potassium, Glucose, and Insulin in Myocardial Infarction

Cited by 22 publications

References 2 publications

Insulin Therapy and In‐Hospital Mortality in Critically Ill Patients: Systematic Review and Meta‐analysis of Randomized Controlled Trials

Insulin Therapy and In‐Hospital Mortality in Critically Ill Patients: Systematic Review and Meta‐analysis of Randomized Controlled Trials

The Difficulty of Appraisal of Streptokinase Treatment of Myocardial Infarction

The effect of insulin on the heart

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