Effect of Glucose- Insulin- Potassium on Plasma Concentrations of C - Reactive Protein in Acute Myocardial Infarction

According to high prevalence and mortality of ischemic heart disease, mention to treatment is important. Glucose–insulin–potassium (GIK) as an adjunctive treatment of ST segment elevation myocardial infarction (STEMI) has been suggested but its effects are controversial. Whereas C-reactive protein (CRP) has prognostic value, we aimed to evaluate the effect of GIK on Plasma concentrations of C-reactive protein in STEMI patients. This randomized clinical trial enrolled 72 patients who had STEMI that were referred to Vaseie hospital of Sabzevar, Iran. Patients were categorized to two groups by block randomization and were treated 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 (CRP) at baseline and sequentially for 48 hours. Baseline CRP)GIK=5.6±5.9,control=4.0±4.3mg/L, p=0.35 (were significantly increased to 3-fold at 48 hours in each group (GIK=16.8±2.2, control=15.5±3.2mg/L, p=0.17). There was no difference in plasma concentrations of CRP between GIK and control patients (p=0.24). Mean glucose level over 6 hours was higher in GIK group (212±13 mg/dL) than control group (142±46 mg/dL, p=0.006). In patients with acute myocardial infarction treated with streptokinase, glucose-insulin-potassium therapy offers no anti-inflammatory effect.