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

• Published in: BMC cardiovascular disorders Vol. 14; no. 1; p. 169
• Main Authors: Jin, Pei-Yin, Zhang, Hai-San, Guo, Xiao-Yan, Liang, Wei-Fang, Han, Qin-Fu
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 25.11.2014; BioMed Central
• Subjects: Acute Coronary Syndrome - complications; Acute Coronary Syndrome - drug therapy; Acute Coronary Syndrome - mortality; Acute coronary syndromes; Analysis; Cardioplegic Solutions - administration & dosage; Cardioplegic Solutions - adverse effects; Chi-Square Distribution; Drug Administration Schedule; Glucose - administration & dosage; Glucose - adverse effects; Heart Arrest - etiology; Heart Arrest - mortality; Heart Arrest - prevention & control; Heart attacks; Hospital Mortality; Humans; Hyperglycemia; Infusions, Parenteral; Insulin - administration & dosage; Insulin - adverse effects; Mortality; Odds Ratio; Potassium - administration & dosage; Potassium - adverse effects; Randomized Controlled Trials as Topic; Risk Factors; Studies; Time Factors; Time-to-Treatment; Treatment Outcome
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/1471-2261-14-169

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. 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. 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. 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.