[Effect of GIK serum on hospital course of patients with ST elevation myocardial infarction]

ABSTRACT

Acute myocardial infarcrion [AMI] is an important cause of mortality and morbidity in our country and all over the world. GIK [glucose-insulin-potassium] with some positive effects on myocardial metabolism has been used in order to improve the clinical course in AMI but in spite of some clinical trials, the effect of GIK on outcome is still controversial. In this clinical trial study, 113 patients with STEMI who referred to Ghaem Hospital [during 1382-83] were divided in 4 groups; 1] GIK +SK [23/9%], 2] GIK [13/3%], 3] SK [37/1%], and 4] none [no GIK, no SK] [25/7%] and clinical [CCU and hospital admission days, post MI angina, reinfarction, heart failure, death], electrocardiographic [arrhythmia] and echocardiographic [L V systolic function] parameters were compared STK was administered to all eligible patients, but GIK patients were selected randomly. From 113 cases with mean age of 59.9 years old, 37.2% received high dose GIK and 61.1% were given STK, there was no difference in age, sex, risk factors [except for smoking], co-medication, region of MI and Killips on admission between GIK and no- GIK patients. Door to niddle time was 47.6 minutes for STK and 92.0 minutes for GIK groups. When comparing the 3 groups, GIK with or without SK and also SK itself, eeu [p=0.16] and hospital days [p= 0.39], reinfarction [p= 0.37], pulmonary edema [p= 0.73], in hospital mortality [p= 0.58], and mean LVEF [p=0.80] were not different significantly. The findings were the same in group 4 [no GIK, no SK], surprisingly. Post MI angina [p= 0.07] and arrhythmia [p= 0.06] in group that received GIK alone were slightly less than STK groups. According to the results of this study, apart from slight reduction of post M I angina and arrhythmia, GIK has no significant effect on hospital course of patients with STEMI