The beneficial effect of insulin, glucose, and dipyridamole on regional left ventricular function early after acute myocardial infarction.

Abstract

BACKGROUND:

High-dose glucose-insulin-potassium (GIK) solution has beneficial effects on reducing mortality in acute myocardial infarction. Dipyridamole (DIP) is a powerful antioxidant and increases adenosine concentration. Experimentally, GIK and DIP have additive protective effects in ischemia-reperfusion injury.

AIM:

This work aims to assess the acute effects of DIP alone, GIK alone, and GIK+DIP on left ventricular function in patients evaluated early after an acute myocardial infarction.

METHODS:

Ten male patients (age 63+/-11 years) with uncomplicated acute myocardial infarction were evaluated within 3 days after admission. All had been treated with systemic thrombolysis and were on full therapy (including beta-blockers) at the time of testing. They underwent stress echocardiography [2D echo, with wall motion score index (WMSI) evaluated in a 16-segment model of the left ventricle, with each segment scored from 1=normal to 4=dyskinetic] during low-dose DIP alone (0.28 mg/kg in 4 min); GIK alone (4-h infusion of glucose 30%, 25 insulin units, and 40 mEq of KCl, at an infusion rate of 1.5 ml/kg/h); and GIK+DIP.

RESULTS:

Regional systolic function (baseline WMSI=1.69+/-0.2) improved after DIP (1.54+/-0.1), GIK (1.54+/-0.1), and, to a greater extent, after GIK+DIP (1.33+/-0.2; p<0.001 vs. baseline; p<0.05 vs. DIP; p<0.05 vs. GIK).

CONCLUSION:

High-dose GIK has an acute beneficial effect on regional left ventricular function in patients with acute myocardial infarction. This beneficial effect is potentiated by low-dose DIP coadministration.

• Authors: Gigliola Bedetti, Carmine Pizzi, Luca Gabrieli, Albert Varga, Emilio Pasanisi, Raffaele Bugiardini, Eugenio Picano
• Journal: International journal of cardiology (Int J Cardiol) Vol. 102 Issue 2 Pg. 255-8 (Jul 10 2005) ISSN: 0167-5273 [Print] Netherlands
• PMID: 15982493 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Insulin
• Vasodilator Agents
• glucose-insulin-potassium cardioplegic solution
• Dipyridamole
• Glucose
• Potassium

Topics

• Dipyridamole (administration & dosage, therapeutic use)
• Drug Therapy, Combination
• Echocardiography, Stress
• Electrocardiography
• Follow-Up Studies
• Glucose (administration & dosage, therapeutic use)
• Heart Ventricles (diagnostic imaging, drug effects, physiopathology)
• Hospital Mortality (trends)
• Humans
• Infusions, Intravenous
• Insulin (administration & dosage, therapeutic use)
• Italy (epidemiology)
• Male
• Middle Aged
• Myocardial Infarction (drug therapy, mortality, physiopathology)
• Potassium (administration & dosage, therapeutic use)
• Retrospective Studies
• Stroke Volume (drug effects)
• Survival Rate (trends)
• Time Factors
• Treatment Outcome
• Vasodilator Agents (administration & dosage, therapeutic use)
• Ventricular Function, Left (drug effects)