Effect of glucose-insulin-potassium on plasma concentrations of C-reactive protein in acute ST- elevation myocardial infarction; a randomized clinical trial

ABSTRACT

The anti inflammatory effects of glucose-insulin-potassium [GIK] in the management of patients with ST segment elevation myocardial infarction [STEMI] are controversial. We aimed to evaluate anti-inflammatory effect of GIK in STEMI patients treated with streptokinase which is not obvious up to now. This randomized clinical trial enrolled 72 patients who had STEMI that were treated within 12 hours from symptom onset with a high dose of GIK [25% glucose, 50 IU of soluble insulin per liter, and 80 m mol of potassium chloride per liter at 1 ml/kg/hour] [GIK group] or normal saline [control group] as adjunct to thrombolytic therapy. We analyzed Plasma concentrations of high-sensitivity C-reactive protein [HS CRP] at baseline and sequentially for 48 hours. Baseline HS CRP were significantly increased [2- to 3-fold] at 24 and 48 hours in each group [P<0.01]. There was no difference in plasma concentrations of HS CRP between GIK and control patients [P = 0.24]. Mean glucose level over 6 hours was higher in GIK group than control group [P=0.006]. GIK therapy offers no anti-inflammatory effect in patients with STEMI treated with streptokinase