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Diabetes and Vascular Disease Research
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Effect of glucose-insulin-potassium (GIK) infusion on biomarkers of cardiovascular risk in ST elevation myocardial infarction (STEMI): insight into the failure of GIK

Shailja V Parikh

Department of Internal Medicine, the University of Texas Southwestern Medical Center in Dallas, Texas, US.

Shuaib M Abdullah

Department of Internal Medicine, the University of Texas Southwestern Medical Center in Dallas, Texas, US.

Ellen C Keeley

Department of Internal Medicine at the University of Virginia in Charlottesville, Virginia, US.

Joaquin E Cigarroa

Department of Internal Medicine at the Oregon Health Science University in Portland, Oregon, US.

Tayo A Addo

Department of Internal Medicine, the University of Texas Southwestern Medical Center in Dallas, Texas, US.

John J Warner

Department of Internal Medicine, the University of Texas Southwestern Medical Center in Dallas, Texas, US.

Amit Khera

Department of Internal Medicine, the University of Texas Southwestern Medical Center in Dallas, Texas, US.

James A De Lemos

Department of Internal Medicine, the University of Texas Southwestern Medical Center in Dallas, Texas, US.

Darren K McGuire

Department of Internal Medicine, the University of Texas Southwestern Medical Center in Dallas, Texas, US.

Glucose-insulin-potassium (GIK) infusion favourably affects several biomarkers associated with risk in the setting of myocardial infarction (MI). In the context of a recent trial demonstrating no benefit of GIK, we assessed the impact of GIK on inflammation, neurohormonal activation and myonecrosis in ST elevation myocardial infarction (STEMI).

In a local substudy of an international randomised trial, 25 patients with STEMI were randomised to receive a 24-hour infusion of GIK vs. no GIK. C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin T (TnT) were assayed at baseline and at 24 hours.

The two groups were well matched for baseline characteristics and infarct location. There were no statistically significant differences at baseline or at 24 hours in levels of hs-CRP, NT-proBNP or cTnT, with similar and significant increases in all three biomarkers by 24 hours in both groups.

In conclusion, GIK had no discernible effect on biomarkers associated with inflammation, neurohormonal activation or myonecrosis, three pathways associated with adverse outcomes in STEMI.

Key Words: biomarkers • glucose-insulin-potassium • insulin • myocardial infarction

Diabetes and Vascular Disease Research, Vol. 4, No. 3, 222-225 (2007)
DOI: 10.3132/dvdr.2007.043
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