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Review
. 2014 Nov 25:14:169.
doi: 10.1186/1471-2261-14-169.

Glucose-insulin-potassium therapy in patients with acute coronary syndrome: a meta-analysis of randomized controlled trials

Pei-Yin Jin  1 , Hai-San Zhang, Xiao-Yan Guo, Wei-Fang Liang, Qin-Fu Han
Affiliations
Review

Glucose-insulin-potassium therapy in patients with acute coronary syndrome: a meta-analysis of randomized controlled trials

Pei-Yin Jin et al. BMC Cardiovasc Disord. .

Abstract

Background: Glucose-insulin-potassium (GIK) has been advocated in the setting of acute coronary syndrome (ACS) to reduce ischemia-related arrhythmias and myocardial injury. We conducted a meta-analysis of randomized controlled trials (RCTs) to assess whether the use of GIK infusions >3 or <3 hours after the onset of symptoms reduce mortality or cardiac arrest.

Methods: Electronic databases (Medline, EMBASE, and Cochrane Central Register of Controlled Trials) and references of retrieved articles were searched for RCTs evaluating the effect of GIK infusions, <3 hours or >3 hours after the onset of symptoms, on mortality and/or cardiac arrest. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for each outcome.

Results: Nine trials were identified and eligible for review. The summary OR for in-hospital mortality was 1.01 (95% CI 0.94 to 1.09), based on 2,542 deaths among 27,294 patients. The subgroup analysis according to the study enrollment time (within 3 hours [OR, 0.77, 95% CI 0.50-1.16], vs. >3 hours [OR, 0.90; 95% CI, 0.67-1.21]) did not reveal any difference in mortality.

Conclusions: Administration of GIK in ACS patients does not significantly reduce mortality whether or not GIK administration >3 or <3 hours after the onset of symptoms.

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Figures

Figure 1
Figure 1
Identification of eligible studies.
Figure 2
Figure 2
Forest plot for in-hospital mortality according to before or after reperfusion.
Figure 3
Figure 3
Forest plot for in-hospital mortality according to timeliness from symptom to treatment (<3 hour or >3 hour).
Figure 4
Figure 4
Meta regression for mortality according to timeliness from symptom to treatment (hours).
See this image and copyright information in PMC

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Pre-publication history
    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2261/14/169/prepub

MeSH terms