Exp Clin Cardiol. 2010;15(2):e20-4.
A meta-analysis of glucose-insulin-potassium therapy for treatment of acute myocardial infarction.
Experimental and clinical cardiology
Mamas A Mamas, Ludwig Neyses, Farzin Fath-Ordoubadi
Affiliations
Affiliations
- Department of Cardiology, Manchester University;
PMID: 20631859
PMCID: PMC2898530
Abstract
BACKGROUND: Glucose-insulin-potassium (GIK) therapy has been proposed to provide metabolic support to ischemic myocardium. A meta-analysis that included 1932 patients performed 10 years previously demonstrated that GIK therapy may have an important role in reducing mortality after acute myocardial infarction (AMI). Since then, many larger randomized trials investigating the role of GIK in the setting of AMI have been published; hence, the present study repeats the previous meta-analysis performed by the current authors to include these trials.
METHOD AND RESULTS: A systematic MEDLINE search for all randomized, placebo-controlled studies of GIK therapy in the setting of AMI was conducted and a meta-analysis of the mortality data was performed. A total of 16 randomized trials from 1966 to 2008 were identified, with 28,374 patients included in the current meta-analysis. There was a total of 1367 deaths (9.6%) in the GIK group, with 1351 deaths (9.6%) in the control group. Meta-analysis did not reveal any benefit from GIK treatment (OR 1.0; 95% CI 0.9 to 1.1; P=0.9). Subgroup analysis of patients given high-dose GIK and in patients in whom reperfusion was not obtained did not demonstrate a benefit from GIK therapy.
CONCLUSION: A meta-analysis of 16 randomized trials that spanned 40 years and involved more than 28,000 patients did not reveal any mortality benefit for ST segment elevation AMI using GIK therapy when data from the modern thrombolysis/primary percutaneous coronary intervention era were included.
Keywords: Insulin; Meta-analysis; Myocardial infarction
References
- Lancet. 1965 Sep 25;2(7413):607-9 - PubMed
- Circulation. 1999 Feb 2;99(4):578-88 - PubMed
- Am J Cardiol. 1962 Feb;9:166-81 - PubMed
- Lancet. 1968 May 4;1(7549):946-8 - PubMed
- Am J Cardiol. 1975 Dec;36(7):929-37 - PubMed
- Circ Res. 1991 Feb;68(2):466-81 - PubMed
- Lancet. 1968 Dec 28;2(7583):1355-60 - PubMed
- Circulation. 1998 Nov 24;98(21):2227-34 - PubMed
- JAMA. 2005 Jan 26;293(4):437-46 - PubMed
- Circulation. 2005 Jun 14;111(23):3078-86 - PubMed
- Br Heart J. 1977 Jul;39(7):748-57 - PubMed
- Lancet. 1994 Jan 15;343(8890):155-8 - PubMed
- Am Heart J. 2004 Jul;148(1):e3 - PubMed
- Am Heart J. 1987 Jul;114(1 Pt 1):54-8 - PubMed
- Acta Med Scand. 1971 Sep;190(3):213-8 - PubMed
- Diabetes Care. 2006 Apr;29(4):765-70 - PubMed
- J Am Coll Cardiol. 2006 Apr 18;47(8):1730-1 - PubMed
- Circulation. 1997 Aug 19;96(4):1152-6 - PubMed
- Eur Heart J. 2005 May;26(10):956-9 - PubMed
- Nature. 1975 Feb 27;253(5494):746-7 - PubMed
- JAMA. 2007 Nov 28;298(20):2399-405 - PubMed
- Eur Heart J. 2006 Jun;27(11):1289-97 - PubMed
- Eur Heart J. 2005 Apr;26(7):650-61 - PubMed
- Am J Cardiol. 2005 Dec 1;96(11):1517-20 - PubMed
- J Am Coll Cardiol. 2003 Sep 3;42(5):784-91 - PubMed
- Am J Med. 2002 Mar;112(4):305-11 - PubMed
- Circulation. 2001 May 22;103(20):2441-6 - PubMed
- Cardiovasc Drugs Ther. 1999 May;13(3):191-200 - PubMed
- Circulation. 1975 Jul;52(1):49-57 - PubMed
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