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Published on: May 28, 2019
Effect of glucose-insulin-potassium infusion on myocardial damage due to percutaneous coronary revascularization
Mustafa Yazici1, Sabri Demircan, Kenan Durna
1Department of Cardiology, Ondokuz Mayis University Medical Faculty, Samsun, Turkey. drmeyaz@hotmail.com
Insights
Glucose-insulin-potassium (GIK) infusion given before percutaneous coronary intervention reduced myocardial damage. This GIK therapy significantly lowered troponin I levels post-procedure in patients with non-ST-elevation acute coronary syndrome.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Percutaneous coronary intervention (PCI) can lead to myocardial damage via microvascular dysfunction, microembolization, and microinfarction.
- Previous research indicates Glucose-Insulin-Potassium (GIK) infusion may decrease mortality in acute myocardial infarction patients.
Purpose of the Study:
- To evaluate the impact of GIK infusion on myocardial damage resulting from percutaneous coronary revascularization.
- To assess GIK's protective effects against myocardial injury during and after PCI.
Main Methods:
- A double-blind, randomized study involving 52 non-diabetic patients with non-ST-elevation acute coronary syndrome undergoing elective PCI.
- Patients were assigned to either GIK infusion or normal saline.
- GIK infusion was administered starting 24 hours before PCI, continuing through the procedure and for 1 hour after. Troponin I levels were measured pre-intervention and at 12 and 24 hours post-intervention.
Main Results:
- The GIK group exhibited significantly lower troponin I levels at both 12 and 24 hours post-PCI compared to the saline control group (p=0.022 and p=0.005).
- This indicates a reduction in myocardial damage in patients receiving GIK infusion.
Conclusions:
- Pre-procedural GIK infusion, initiated 24 hours before coronary stenting for non-ST-elevation acute coronary syndrome, effectively minimizes myocardial damage.
- GIK infusion shows promise as a protective strategy against PCI-induced myocardial injury.
Abstract:
Percutaneous coronary intervention has been known to cause myocardial damage as a result of microvascular dysfunction due to microembolization and microinfarction. Previous studies have shown that glucose-insulin-potassium (GIK) infusion decreases mortality in patients with acute myocardial infarction. Therefore, in this study, we aimed to investigate the effect of GIK infusion on myocardial damage due to percutaneous coronary revascularization. A total of 52 consecutive nondiabetic patients diagnosed with non-ST-elevation acute coronary syndrome and designated for elective percutaneous coronary intervention were randomized in a double-blind fashion into GIK and normal saline groups. GIK infusion (30% dextrose, 300 U insulin, and 60 mEq potassium chloride) at a dose of 1.5 ml/kg/hour was initiated 24 hours before the intervention and continuing during and until 1 hour after the intervention. Troponin I levels were recorded in venous blood samples before and 12 and 24 hours after the intervention. The increase in troponin I was significantly lower at 12 and 24 hours in the GIK group compared with those of the saline controls (p=0.022 and p=0.005, respectively). GIK infusion initiated 24 hours before coronary stenting for non-ST-elevation acute coronary syndrome resulted in less myocardial damage as determined by postprocedure troponin I levels.
