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

[Efficacy of propranolol and amiodarone on prevention of atrial fibrillation after CABG]

Atrial fibrillation is the most common arrhythmia following CABG. This complication can cause palpitation, significant hemodynamic instability and thromboembolic events. This prospective randomized study evaluate prophylactic effects of propranolol low dose amiodarone and high dose amiodarone in patients candidate for CABG. Three hundred consecutive patients undergoing elective CABG were randomly categorized into three groups [each group contains 100 patients]. Patients in group1 [control group] received 10mg/TDS propranolol per oral [P.o], preoperatively. Patients in group 2 received 10mg propranolol TDS, P.o plus 350mg/24h amiodarone. Patients in group 3 received 10mg propranolol TDS P.o plus 1000mg/24h amiodarone 24 hours before operation. Atrial fibrillation occurred in 12 patients [12%] in group 1, four patients [4%] in group 2 and 10 patients [10%] [P=0.035] in group 3. AF occurred in 10.36% of men and 3.84% of women. There was no AF in off- pump groups and 9.73% in on-pump groups This study suggested the combination of propranolol plus low dose amiodarone for post CABG atrial fibrillation prophylaxy