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Glucose-insulin-potassium therapy in patients with acute coronary syndrome: a meta-analysis of randomized controlled trials.

Jin PY, Zhang HS, Guo XY, Liang WF, Han QF - BMC Cardiovasc Disord (2014)

Bottom Line: Glucose-insulin-potassium (GIK) has been advocated in the setting of acute coronary syndrome (ACS) to reduce ischemia-related arrhythmias and myocardial injury.The subgroup analysis according to the study enrollment time (within 3 hours [OR, 0.77, 95% CI 0.50-1.16], vs. >3 hours [OR, 0.90; 95% CI, 0.67-1.21]) did not reveal any difference in mortality.Administration of GIK in ACS patients does not significantly reduce mortality whether or not GIK administration >3 or <3 hours after the onset of symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, The People's Hospital of Anyang, Anyang, Henan, China. 13323729039@189.cn.

ABSTRACT

Background: Glucose-insulin-potassium (GIK) has been advocated in the setting of acute coronary syndrome (ACS) to reduce ischemia-related arrhythmias and myocardial injury. We conducted a meta-analysis of randomized controlled trials (RCTs) to assess whether the use of GIK infusions >3 or <3 hours after the onset of symptoms reduce mortality or cardiac arrest.

Methods: Electronic databases (Medline, EMBASE, and Cochrane Central Register of Controlled Trials) and references of retrieved articles were searched for RCTs evaluating the effect of GIK infusions, <3 hours or >3 hours after the onset of symptoms, on mortality and/or cardiac arrest. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for each outcome.

Results: Nine trials were identified and eligible for review. The summary OR for in-hospital mortality was 1.01 (95% CI 0.94 to 1.09), based on 2,542 deaths among 27,294 patients. The subgroup analysis according to the study enrollment time (within 3 hours [OR, 0.77, 95% CI 0.50-1.16], vs. >3 hours [OR, 0.90; 95% CI, 0.67-1.21]) did not reveal any difference in mortality.

Conclusions: Administration of GIK in ACS patients does not significantly reduce mortality whether or not GIK administration >3 or <3 hours after the onset of symptoms.

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Related in: MedlinePlus

Forest plot for in-hospital mortality according to timeliness from symptom to treatment (<3 hour or >3 hour).
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Fig3: Forest plot for in-hospital mortality according to timeliness from symptom to treatment (<3 hour or >3 hour).

Mentions: The potential benefit of GIK is thought to be related to timeliness of administration after onset of cardiac ischemia, so we did subgroup analysis according to time from onset of symptom to treatment (with 3 hours vs. >3 hours). Two RCTs [5, 13] evaluated the effect of receiving GIK within 3 hours from onset of symptom to treatment and found no significant reduction in mortality (OR 0.77, 95% CI 0.50 to 1.16, p = 0.21). Four trials [4, 11, 12, 15] studied the effect of GIK >3 hours from onset of symptom to treatment. Overall, there was no significant reduction in mortality (OR 0.90; 95% CI, 0.67-1.21, p = 0.48) (Figure 3).Figure 3


Glucose-insulin-potassium therapy in patients with acute coronary syndrome: a meta-analysis of randomized controlled trials.

Jin PY, Zhang HS, Guo XY, Liang WF, Han QF - BMC Cardiovasc Disord (2014)

Forest plot for in-hospital mortality according to timeliness from symptom to treatment (<3 hour or >3 hour).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4256054&req=5

Fig3: Forest plot for in-hospital mortality according to timeliness from symptom to treatment (<3 hour or >3 hour).
Mentions: The potential benefit of GIK is thought to be related to timeliness of administration after onset of cardiac ischemia, so we did subgroup analysis according to time from onset of symptom to treatment (with 3 hours vs. >3 hours). Two RCTs [5, 13] evaluated the effect of receiving GIK within 3 hours from onset of symptom to treatment and found no significant reduction in mortality (OR 0.77, 95% CI 0.50 to 1.16, p = 0.21). Four trials [4, 11, 12, 15] studied the effect of GIK >3 hours from onset of symptom to treatment. Overall, there was no significant reduction in mortality (OR 0.90; 95% CI, 0.67-1.21, p = 0.48) (Figure 3).Figure 3

Bottom Line: Glucose-insulin-potassium (GIK) has been advocated in the setting of acute coronary syndrome (ACS) to reduce ischemia-related arrhythmias and myocardial injury.The subgroup analysis according to the study enrollment time (within 3 hours [OR, 0.77, 95% CI 0.50-1.16], vs. >3 hours [OR, 0.90; 95% CI, 0.67-1.21]) did not reveal any difference in mortality.Administration of GIK in ACS patients does not significantly reduce mortality whether or not GIK administration >3 or <3 hours after the onset of symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, The People's Hospital of Anyang, Anyang, Henan, China. 13323729039@189.cn.

ABSTRACT

Background: Glucose-insulin-potassium (GIK) has been advocated in the setting of acute coronary syndrome (ACS) to reduce ischemia-related arrhythmias and myocardial injury. We conducted a meta-analysis of randomized controlled trials (RCTs) to assess whether the use of GIK infusions >3 or <3 hours after the onset of symptoms reduce mortality or cardiac arrest.

Methods: Electronic databases (Medline, EMBASE, and Cochrane Central Register of Controlled Trials) and references of retrieved articles were searched for RCTs evaluating the effect of GIK infusions, <3 hours or >3 hours after the onset of symptoms, on mortality and/or cardiac arrest. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for each outcome.

Results: Nine trials were identified and eligible for review. The summary OR for in-hospital mortality was 1.01 (95% CI 0.94 to 1.09), based on 2,542 deaths among 27,294 patients. The subgroup analysis according to the study enrollment time (within 3 hours [OR, 0.77, 95% CI 0.50-1.16], vs. >3 hours [OR, 0.90; 95% CI, 0.67-1.21]) did not reveal any difference in mortality.

Conclusions: Administration of GIK in ACS patients does not significantly reduce mortality whether or not GIK administration >3 or <3 hours after the onset of symptoms.

Show MeSH
Related in: MedlinePlus