Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Acute coronary syndromes

Early metabolic modulation—a solution for MI?

Infusion of glucose–insulin–potassium (GIK) before hospital admission in patients with signs and symptoms of acute coronary syndrome has been shown to reduce the incidence of cardiac arrest or in-hospital mortality. Whether out-of-hospital GIK in combination with strict glycemic control can prevent progression to MI requires further study.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Goulston, A. West Indian cane sugar in treatment of certain forms of heart disease. BMJ 2, 693–695 (1912).

    Google Scholar 

  2. Sodi-Pallares, D. et al. Effects of an intravenous infusion of a potassium–glucose–insulin solution on the electrocardiographic signs of myocardial infarction. A preliminary clinical report. Am. J. Cardiol. 9, 166–181 (1962).

    Article  CAS  Google Scholar 

  3. Apstein, C. S. & Taegtmeyer, H. Glucose–insulin–potassium in acute myocardial infarction: the time has come for a large, prospective trial. Circulation 96, 1074–1077 (1997).

    Article  CAS  Google Scholar 

  4. Goyal, A., Nerenberg, K., Gerstein, H. C., Umpierrez, G. & Wilson, P. W. Insulin therapy in acute coronary syndromes: an appraisal of completed and ongoing randomised trials with important clinical end points. Diab. Vasc. Dis. Res. 5, 276–284 (2008).

    Article  Google Scholar 

  5. Selker, H. P. et al. Study design for the Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency Care (IMMEDIATE) trial: a double-blind randomized controlled trial of intravenous glucose, insulin, and potassium for acute coronary syndromes in emergency medical services. Am. Heart J. 163, 315–322 (2012).

    Article  CAS  Google Scholar 

  6. Selker, H. P. et al. Out-of-hospital administration of intravenous glucose–insulin–potassium in patients with suspected acute coronary syndromes: the IMMEDIATE randomized controlled trial. JAMA 307, 1925–1933 (2012).

    Article  CAS  Google Scholar 

  7. van der Horst, I. C. et al. Glucose and potassium derangements by glucose–insulin–potassium infusion in acute myocardial infarction. Neth. Heart J. 14, 89–94 (2006).

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Timmer, J. R. et al. Prognostic value of admission glycosylated hemoglobin and glucose in nondiabetic patients with ST-segment-elevation myocardial infarction treated with percutaneous coronary intervention. Circulation 124, 704–711 (2011).

    Article  CAS  Google Scholar 

  9. Marfella, R. et al. Tight glycemic control may increase regenerative potential of myocardium during acute infarction. J. Clin. Endocrinol. Metab. 97, 933–942 (2012).

    Article  CAS  Google Scholar 

  10. van der Horst, I. C. et al. The impact of glucose–insulin–potassium infusion in acute myocardial infarction on infarct size and left ventricular ejection fraction [ISRCTN56720616]. BMC Med. 3, 9 (2005).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

van der Horst, I. Early metabolic modulation—a solution for MI?. Nat Rev Cardiol 9, 377–378 (2012). https://doi.org/10.1038/nrcardio.2012.75

Download citation

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/nrcardio.2012.75

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing