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

Autor: Alkofide H; 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., Huggins GS; MCRI Center for Translational Genomics, Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, USA., Beshansky JR; 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., Ruthazer R; 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., Peter I; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Ray M; Clinical and Translational Science Graduate Program, Sackler School of Biomedical Sciences, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA., Mukherjee JT; 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., Selker HP; Center for Cardiovascular Health Services Research, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA. hselker@tuftsmedicalcenter.org.; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA. hselker@tuftsmedicalcenter.org.
Jazyk: angličtina
Zdroj: BMC cardiovascular disorders [BMC Cardiovasc Disord] 2015 Dec 03; Vol. 15, pp. 163. Date of Electronic Publication: 2015 Dec 03.
DOI: 10.1186/s12872-015-0153-7
Abstrakt: Background: Some 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 Results: Retrospective 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.
Conclusions: The 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.
Databáze: MEDLINE
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