C-Reactive protein reactions to glucose-insulin-potassium infusion and relations to infarct size in patients with acute coronary syndromes

BMC Cardiovascular Disorders

Research Article

Joni R. Beshansky¹  Harry P. Selker²  Robin Ruthazer²  Madhab Ray³  Hadeel Alkofide⁴  Jayanta T. Mukherjee⁵  Inga Peter⁶  Gordon S. Huggins⁷ 

[1] Center for Cardiovascular Health Services Research, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA;Regulatory and Clinical Research Management, Department of Health Sciences, Regis College, Weston, MA, USA;Center for Cardiovascular Health Services Research, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA;Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA;Clinical and Translational Science Graduate Program, Sackler School of Biomedical Sciences, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA;Clinical and Translational Science Graduate Program, Sackler School of Biomedical Sciences, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA;Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia;Clinical and Translational Science Graduate Program, Sackler School of Biomedical Sciences, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA;Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA;Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA;MCRI Center for Translational Genomics, Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, USA;

关键词: Acute coronary syndromes;    Glucose-insulin-potassium (GIK);    Inflammation;    C-reactive protein;    Metabolic therapy;   

DOI  :  10.1186/s12872-015-0153-7

 received in 2015-01-16, accepted in 2015-11-19,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundSome benefits of glucose-insulin-potassium (GIK) in patients with acute coronary syndromes (ACS) may be from an anti-inflammatory effect. The primary aim of this study was to assess the impact of GIK administration early in the course of ACS on inflammatory marker C-reactive protein (CRP) levels. A secondary aim was to investigate the association between CRP and 30-day infarct size.Methods and ResultsRetrospective analysis of participants with ACS randomly assigned to GIK or placebo for at least 8 h in the IMMEDIATE Trial biological mechanism cohort (n = 143). High sensitivity CRP (hs-CRP) was measured at emergency department presentation, and 6 and 12 h into infusion. Logarithmically transformed hs-CRP values at 12-hours were lower with GIK vs. placebo (mean =0.65 mg/L in GIK, 0.84 mg/L in placebo), with a marginal trend toward significance (P = 0.053). Furthermore, using mixed models of hs-CRP, time, and study group, there was a significant increase in hs-CRP levels over time, but the rate of change did not differ between treatment arms (P = 0.3). Multivariable analysis showed that an elevation in hs-CRP, measured at 12 h, was an independent predictor of 30-day infarct size (β coefficient, 6.80; P = 0.04) using sestamibi SPECT imaging.ConclusionsThe results of this study show no significant effect of GIK on hs-CRP. In addition our results show that in patients with ACS, hs-CRP measured as early as 12 h can predict 30-day infarct size.

【 授权许可】

CC BY   
© Alkofide et al. 2015