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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

Meta regression for mortality according to timeliness from symptom to treatment (hours).
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Fig4: Meta regression for mortality according to timeliness from symptom to treatment (hours).

Mentions: Only six [4, 5, 11–13, 15] of the eligible nine studies reported data on time from onset of symptom to treatment. Meta-regression was used to assess the possible influence of time from onset of symptom to treatment of the six studies [4, 5, 11–13, 15] on the mortality outcome (Figure 4). This analysis showed that heterogeneity could not be explained by time from onset of symptom to treatment (coefficient =0.032, p = 0.639).Figure 4


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)

Meta regression for mortality according to timeliness from symptom to treatment (hours).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig4: Meta regression for mortality according to timeliness from symptom to treatment (hours).
Mentions: Only six [4, 5, 11–13, 15] of the eligible nine studies reported data on time from onset of symptom to treatment. Meta-regression was used to assess the possible influence of time from onset of symptom to treatment of the six studies [4, 5, 11–13, 15] on the mortality outcome (Figure 4). This analysis showed that heterogeneity could not be explained by time from onset of symptom to treatment (coefficient =0.032, p = 0.639).Figure 4

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