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Research Article
 
DOI:10.11909/j.issn.1671-5411.2020.09.004
Effects and mechanisms of glucose-insulin-potassium on post-procedural myocardial injury after percutaneous coronary intervention
Yi-Dan HAO,Peng HAO,Zheng WANG,Ying-Xin ZHAO,Zhi-Ming ZHOU,Yu-Yang LIU,De-An JIA,Hong-Ya HAN,Bin HU,Hua SHEN,Fei GAO,Guo-Zhong PAN,Zhen-Feng GUO,Shi-Wei YANG,Yu-Jie ZHOU.Effects and Mechanisms of Glucose-Insulin-Potassium on Post-procedural Myocardial Injury After Percutaneous Coronary InterventionJ Geriatr Cardiol 2020,17(9):554~560
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Authors:Yi-Dan HAO1;Peng HAO1;Zheng WANG2;Ying-Xin ZHAO3;Zhi-Ming ZHOU3;Yu-Yang LIU3;De-An JIA3;Hong-Ya HAN3;Bin HU3;Hua SHEN3;Fei GAO3;Guo-Zhong PAN4;Zhen-Feng GUO5;Shi-Wei YANG6;Yu-Jie ZHOU6

Author Affiliation:1.Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease, the Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing, China;2.Peking University Third Hospital, Beijing, China;3.Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease, the Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing, China;4.Dongzhimen Hospital Eastern Affiliated to Beijing University of Chinese Medicine, Beijing, China;5.Benq Medical Center, Nanjing Medical University, Nanjing, China;6.Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease, the Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing, China;

Foundation:

Abstract: Objective To evaluate the effects and mechanisms of glucose-insulin-potassium (GIK) on post-procedural myocardial injury (PMI) after percutaneous coronary intervention (PCI). Methods A total of 200 non-diabetic patients with documented coronary heart disease (CHD) were divided into the Group GIK and Group G, with 100 patients in each group. Patients in Group G were given intravenous infusion of glucose solution 2 hours before PCI. As compared, patients in Group GIK were given GIK. Results Both post-procedural creatine phosphokinase isoenzyme MB (CK-MB; 62.1 ± 47.8 vs. 48.8 ± 52.6 U/L, P = 0.007) and cTnI (0.68 ± 0.83 vs. 0.19 ± 0.24 ng/mL, P < 0.001) in Group GIK were significantly higher than those in Group G. In Group G, 9.0% and 4.0% of patients had post-procedural increases in CK-MB 1-3 times and > 3 times, which were significantly lower than those in Group GIK (14.0% and 7.0%, respectively; all P values < 0.01); 13.0% and 7.0% of patients had post-procedural increases in cTnI 1-3 times and > 3 times, which were also significantly lower than those in Group GIK (21.0% and 13.0%, respectively; all P < 0.001). Pre-procedural (10.2 ± 4.5 vs. 5.1 ± 6.3, P < 0.001) and post-procedural rapid blood glucose (RBG) levels (8.9 ± 3.9 vs. 5.3 ± 5.6, P < 0.001) in Group G were higher than those in Group GIK. In adjusted logistic models, usage of GIK (compared with glucose solution) remained significantly and independently associated with higher risk of post-procedural increases in both CK-MB and cTnI levels > 3 times. Furthermore, pre-procedural RBG levels < 5.0 mmol/L were significantly associated with higher risk of post-procedural increases in both CK-MB and cTnI levels. Conclusions In non-diabetic patients with CHD, the administration of GIK may increase the risk of PMI due to hypoglycemia induced by GIK.

Keywords:

Glucose-insulin-potassium; Post-procedural myocardial injury; Percutaneous coronary intervention; Hypoglycemia
Received:June 22, 2020        Accepted:September 26, 2020   Published Online:September 28, 2020
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