Glucose-insulin-potassium therapy in the era of coronary revascularization

Glucose-insulin-potassium (GIK) utilization in the treatment of acute myocardial infarction (AMI) has been studied since the early 1960s with varying results. It is well established that ischemic myocardial cells convert from aerobic metabolism of glucose to toxic anaerobic free fatty acid (FFA) metabolism for the production of energy. It has been hypothesized that administration of GIK during coronary revascularization would decrease the degree of myocardial damage. Earlier clinical trials, before the revascularization era, demonstrated a potential role for GIK therapy to reduce the mortality and morbidity associated with AMI. In recent years, GIK therapy has been incorporated into current revascularization methods without clear evidence as to its efficacy. Based on the most current studies, it has been determined that GIK therapy is not beneficial in patients with AMI, regardless of revascularization status, and therefore should not be used.