Effect of glucose–insulin–potassium on Plasma concentrations of C-reactive protein in acute ST- Elevation Myocardial Infarction; A Randomized Clinical Trial

Objective: The anti inflammatory effects of glucose–insulin–potassium (GIK) in the management of patients with ST segment elevation myocardial infarction (STEMI) are controversial. We aimed to evaluate anti-inflammatory effect of GIK in STEMI patients treated with streptokinase which is not obvious up to now. Methodology: This randomized clinical trial enrolled 72 patients who had STEMI that were treated within 12 hours from symptom onset 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 (HS CRP) at baseline and sequentially for 48 hours. Results: Baseline HS CRP were significantly increased (2- to 3-fold) at 24 and 48 hours in each group (P 0.01). There was no difference in plasma concentrations of HS CRP between GIK and control patients (P = 0.24). Mean glucose level over 6 hours was higher in GIK group than control group (P=0.006). Conclusion: GIK therapy offers no anti-inflammatory effect in patients with STEMI treated with streptokinase.