GLUCOSE-INSULIN-POTASSIUM THERAPY REDUCES COMPLICATIONS IN ACUTE MYOCARDIAL-INFARCTION - ARGUMENTS IN FAVOR

Several therapeutic approaches have been proposed for the management o f acute myocardial infarction (AMI). In 1961, Sodi-Pallares presented the Glucose-Insuline-Potassium (GIK) infusion as a valid adjunctive th erapy for the treatment of the acute phase. Ne observed a decrease in mortality which could be explained by some mechanisms such as: arrhyth mia prevention, hypoxic cell nutrition, diminution of infarct size and others. Due to the lack of Coronary Care Units at that time, acute my ocardial ischemia was considered a high mortality disease. Therefore, the first studies concerning the efficacy of this treatment showed a s ignificant decrease in mortality. After the development of better care and medical attention of AMI patients, and above all after the introd uction of fibrinolysis, mortality dramatically diminished. Thus, GIK w as considered to give no additional benefit, and its use became restri cted to a small number of centers. In this review the physiopathologic al bases of GIK solution use are given, as well as the results of the main experimental studies and a critical analysis of the scarce clinic al studies available. It is concluded that there are enough data to su pport the use of GIK solution in non-thrombolyzed AMIs. It could proba bly also benefit thrombolysed ones, although there is no available evi dence in this context.