Glucose‐Insulin‐Potassium‐Albumin Infusion in the Early Phase of Acute Myocardial Infarction—A Controlled Study

Abstract

Consecutive patients (50) with acute myocardial infarction admitted to a coronary care unit within 6 h from onset of symptoms were randomly assigned either to a treatment group (n = 27) receiving glucose-insulin-potassium-albumin (GIKA) or to a control group (n = 23), comparable regarding clinical data, receiving 5.5% glucose. Both infusions were given i.v. at a rate of 1.2 ml/kg body wt/h during 48 h. The GIKA solution contained 40 meq K+, 10 ml 20% albumin and 16 IU regular crystalline insulin per 1000 ml 10% glucose. Before infusion, the treatment group received an i.v. loading dose of 50 ml 50% glucose. Serum time activity curves for creatine kinase (CK) and myoglobin (MG) were established from frequent blood level determinations. A 15-min single-lead ECG was recorded every 4th h and subsequently analyzed for ventricular arrhythmias. The 2 patient groups did not differ regarding cumulative MG and CK release. The GIKA group had significantly more patients with high MG/CK ratios (P < 0.02). No clinically significant difference was found between the 2 patient groups regarding ventricular arrhythmias, even if ventricular extrasystoles tended to occur less frequently in the GIKA group.