Effects and mechanisms of glucose-insulin-potassium on post-procedural myocardial injury after percutaneous coronary intervention  

作　　者：Yi-Dan HAO Peng HAO Zheng WANG Ying-Xin ZHAO Zhi-Ming ZHOU Yu-Yang LIU De-An JIA Hong-Ya HAN Bin HU Hua SHEN Fei GAO Guo-Zhong PAN Zhen-Feng GUO Shi-Wei YANG Yu-Jie ZHOU 

机构地区：[1]Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Disease,the Key Laboratory of Remodeling-related Cardiovascular Disease,Ministry of Education,Beijing,China [2]Peking University Third Hospital,Beijing,China [3]Dongzhimen Hospital Eastern Affiliated to Beijing University of Chinese Medicine,Beijing,China [4]Benq Medical Center,Nanjing Medical University,Nanjing,China

出　　处：《Journal of Geriatric Cardiology》2020年第9期554-560,共7页老年心脏病学杂志（英文版）

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);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.

摘　　要：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.

关 键 词：Glucose-insulin-potassium Post-procedural myocardial injury Percutaneous coronary intervention Hypoglycemia 

分 类 号：R541.4[医药卫生—心血管疾病]