Another Look at Glucose-Insulin-Potassium Infusion After MI

For decades, some have advocated intravenous infusion of glucose-insulin-potassium (GIK) soon after myocardial infarction. Advocates tout the benefit of maximizing myocardial glucose uptake (rather than fatty-acid uptake) to minimize injury and provide glucose to the ischemic myocardium. Does GIK infusion have a role in the age of reperfusion therapy?

In an open-label study from the Netherlands, researchers randomized 940 patients with ST-segment-elevation MI to receive either an 8- to 12-hour GIK infusion or no infusion (control). All patients underwent catheterization and, if appropriate, percutaneous transluminal coronary angioplasty.

The 2 groups had similar 30-day mortality rates (GIK, 4.8%; control, 5.8%). However, among patients withou…