Objective To evaluate the effects and mechanisms of glucose-insulin-potassium(GIK)on post-procedural myocardial injury(PMI)after percutaneous coronary intervention(PCI).Methods A total of 200 non-diabetic patients wit...Objective To evaluate the effects and mechanisms of glucose-insulin-potassium(GIK)on post-procedural myocardial injury(PMI)after percutaneous coronary intervention(PCI).Methods A total of 200 non-diabetic patients with documented coronary heart disease(CHD)were divided into the Group GIK and Group G,with 100 patients in each group.Patients in Group G were given intravenous infusion of glucose solution 2 hours before PCI.As compared,patients in Group GIK were given GIK.Results Both post-procedural creatine phosphokinase isoenzyme MB(CK-MB;62.1±47.8 vs.48.8±52.6 U/L,P=0.007)and cTnI(0.68±0.83 vs.0.19±0.24 ng/mL,P<0.001)in Group GIK were significantly higher than those in Group G.In Group G,9.0%and 4.0%of patients had post-procedural increases in CK-MB 1-3 times and>3 times,which were significantly lower than those in Group GIK(14.0%and 7.0%,respectively;all P values<0.01);13.0%and 7.0%of patients had post-procedural increases in cTnI 1-3 times and>3 times,which were also significantly lower than those in Group GIK(21.0%and 13.0%,respectively;all P<0.001).Pre-procedural(10.2±4.5 vs.5.1±6.3,P<0.001)and post-procedural rapid blood glucose(RBG)levels(8.9±3.9 vs.5.3±5.6,P<0.001)in Group G were higher than those in Group GIK.In adjusted logistic models,usage of GIK(compared with glucose solution)remained significantly and independently associated with higher risk of post-procedural increases in both CK-MB and cTnI levels>3 times.Furthermore,pre-procedural RBG levels<5.0mmol/L were significantly associated with higher risk of post-procedural increases in both CK-MB and cTnI levels.Conclusions In non-diabetic patients with CHD,the administration of GIK may increase the risk of PMI due to hypoglycemia induced by GIK.展开更多
基金Acknowledgement This work was supported by the Beijing Nova Program （No. Z121107002512053）, the Beijing Health System High Level Health Technology Talent Cultivation Plan （No. 2013-3-013）, the Beijing Outstanding Talent Training Program （No. 2014000021223ZK32）, and the National Natural Science Foundation of China （No. 81100143） to S.W.Y., and the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support （No. ZYLX201303） to Y.J.Z.
文摘ObjectiveTo 与 .MethodsWe 测量了的冠的动脉疾病(CAD ) 的严厉和在 18,115 个 CAD 病人的浆液电解质由冠的 angiography 显示了的预后评估在浆液阴离子差距(AG ) 之间的协会。浆液 AG 根据方程被计算：AG = Na <sup>+</sup>[(mmol/L)+ K <sup>+</sup>(mmol/L )][Cl <sup></sup>(mmol/L )+ HCO3 <sup></sup>(mmol/L )] 4510 的 .ResultsA 总数(24.9%) 参加者有他们比 16 mmol/L 大的 AG 层次。浆液 AG 独立地与 CAD 严厉的措施被联系，包括 CAD 的更严重的临床的类型(P < 0.001 ) 并且更坏的心脏的功能(P = 0.004 ) 。病人在第 4 浆液 AG (15.92 mmol/L ) 方照 5.171 褶层增加了 30 天所有原因死亡的风险(P < 0.001 ) 。这个协会好久是柔韧的，甚至在调整以后，性，评估 glomerular 过滤率[危险比率(HR ) ：4.861， 95% 信心间隔(CI ) ：2.150-10.993， P < 0.001 ] ，临床的诊断，冠的动脉狭窄的严厉，心脏的功能等级，和另外的 confounders (HR：3.318， 95% CI：1.76-2.27， P = 0.009 ).ConclusionIn 这大基于人口的研究，我们的调查结果在 CAD 揭示增加的浆液 AG 的一个高百分比。更高的 AG 与 CAD 和更坏的心脏的功能的更严重的临床的类型被联系。而且，增加的浆液 AG 是所有原因死亡的一个独立、重要、强壮的预言者。这些调查结果支持为在 CAD 的风险层化的浆液 AG 的一个角色。
基金The report was supported by grants from the Beijing Nova Program(No.Z121107002512053)the Beijing Health System High Level Health Technology Talent Cultivation Plan(No.2013-3-013)+3 种基金Beijing Outstanding Talent Training Program(No.2014000021223ZK32)the National Natural Science Foundation of China(No.81100143)the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(No.ZYLX 201303)and the National Key Clinical Speciality Construction Project.
文摘Objective To evaluate the effects and mechanisms of glucose-insulin-potassium(GIK)on post-procedural myocardial injury(PMI)after percutaneous coronary intervention(PCI).Methods A total of 200 non-diabetic patients with documented coronary heart disease(CHD)were divided into the Group GIK and Group G,with 100 patients in each group.Patients in Group G were given intravenous infusion of glucose solution 2 hours before PCI.As compared,patients in Group GIK were given GIK.Results Both post-procedural creatine phosphokinase isoenzyme MB(CK-MB;62.1±47.8 vs.48.8±52.6 U/L,P=0.007)and cTnI(0.68±0.83 vs.0.19±0.24 ng/mL,P<0.001)in Group GIK were significantly higher than those in Group G.In Group G,9.0%and 4.0%of patients had post-procedural increases in CK-MB 1-3 times and>3 times,which were significantly lower than those in Group GIK(14.0%and 7.0%,respectively;all P values<0.01);13.0%and 7.0%of patients had post-procedural increases in cTnI 1-3 times and>3 times,which were also significantly lower than those in Group GIK(21.0%and 13.0%,respectively;all P<0.001).Pre-procedural(10.2±4.5 vs.5.1±6.3,P<0.001)and post-procedural rapid blood glucose(RBG)levels(8.9±3.9 vs.5.3±5.6,P<0.001)in Group G were higher than those in Group GIK.In adjusted logistic models,usage of GIK(compared with glucose solution)remained significantly and independently associated with higher risk of post-procedural increases in both CK-MB and cTnI levels>3 times.Furthermore,pre-procedural RBG levels<5.0mmol/L were significantly associated with higher risk of post-procedural increases in both CK-MB and cTnI levels.Conclusions In non-diabetic patients with CHD,the administration of GIK may increase the risk of PMI due to hypoglycemia induced by GIK.
