Effect of glucose - insulin - potassium [GIK] solution on short term prognosis of unstable angina

Unstable angina as a clinical condition includes a major group of patients manifested with acute coronary syndrome. Misdiagnosis of this clinical syndrome causes myocardial infarction [MI] and death. Conventional and advanced forms of treatment are used with the aim of rapid stabilization of unstable angina. Although infusion of glucose - insulin - potassium [GIK] solution has had good results in acute MI, no major trial has studied its effect in unstable angina. The main goal of this study was evaluation of the effectiveness of GIK solution on prognosis of hospitalized unstable angina patients. This randomized clinical trial included patients with class II and III unstable angina [two groups of 94 patients, each] with a mean age of 62.47 +/- 13.20 years and Female /Male ratio of 1.35 admitted in the CCU's of Yazd from September 2003 to May 2004. There was no significant difference between the study and control groups regarding mean age, sex ratio and unstable angina class [P = 0.15, P = 0.77 and P = 0.76]. The study group had significant reduction in recurrent chest pain and duration of hospitalization [P = 0.001 and P = 0.02]. The most common adverse effect ofGIK solution was pain at infusion site. Use of GIK solution causes early stabilization of unstable angina patients without any significant or life threatening adverse effect

[Relation between admission blood glucose levels and in-hospital and one year mortality in non-diabetic acute myocardial infarction patients]

Several studies have evaluated the association of admission blood glucose levels and short and long term mortality after myocardial infarction and have had different results. The aim of this study was evaluation of association between admission blood glucose levels and in-hospital and one year mortality in non-diabetic patients with AMI. In this study, demographic, clinical and Para clinical data of 120 non-diabetic patients with AMI on admission was collected and analyzed. The patients were followed for one year. Blood glucose level >/= 140 mg/dl was defined as hyperglycemia. 78% of patients were men. The mean age and admission blood glucose level was 63 +/- 13 years and 146 +/- 76mg/dl, respectively. Death due to cardio vascular causes was seen in 20% of patients in hospital and 9.8% during the one year follow up. The mean admission blood glucose level in patients who died in hospital was significantly more than live patients and also had an influence on the in-hospital outcome. Every 100mg/dl increase in blood glucose level was associated with 11% increase in in-hospital mortality risk in non-diabetic patients. Our results demonstrate that admission blood glucose level is a good marker for diagnosing patients with worse prognosis after AMI. We suggest that later studies should focus on optimal control of hyperglycemia with insulin in patients with AMI

[Role of obesity in premature MI occurrence and hospital and one year follow up mortality]

Nowadays, obesity is developing as an epidemy and it is one of major risk factors of coronary artery disease, therefore this study determinated the effect of obesity on age of occurrence of MI and It's mortality. In this prospective study we studied on 212 hospitalized patients because of MI in CCU[s] from May 2001 to October 2002 and they followed for one year, questionnaires for all patients were completed and data analyzed with SPSS ver.11.00.. 34.9% of patients were overweight and 16.5% were obese. Average BMI was 25.87 +/- 4.38. Obese patients were younger than overweight and normal weight patients significantly. [P=0.039] there was a linear relationship between BMI and age of occurrence of MI. [P=0.005]. Obesity and overweight status didn't affect on hospital and late [1 year] mortality. According to our results, obesity associated with premature occurrence of AMI because obesity accelerated coronary atherosclerosis but obesity didn't associate with increased incidence of inhopsital or one year mortality. Thus we suggest to long term follow up in later studies