Effects of high-dose glucose-insulin-potassium on acute coronary syndrome patients receiving reperfusion therapy:a meta-analysis  

作　　者：Zeyu Yang Huiruo Liu Dazhou Lu Shengchuan Cao Feng Xu Chuanbao Li 

机构地区：[1]Department of Emergency Medicine,Qilu Hospital of Shandong University,Jinan 250012,China [2]Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine,Institute of Emergency and Critical Care Medicine of Shandong University,Chest Pain Center,Qilu Hospital of Shandong University,Jinan 250012,China [3]Key Laboratory of Emergency and Critical Care Medicine of Shandong Province,Key Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong Province,Shandong Provincial Engineering Laboratory for Emergency and Critical Care Medicine,Qilu Hospital of Shandong University,Jinan 250012,China [4]Shandong Key Laboratory:Magnetic Field-free Medicine&Functional Imaging(MF),Qilu Hospital of Shandong University,Jinan 250012,China [5]National Medical Products Administration(NMPA)Key Laboratory for Clinical Research and Evaluation of Innovative Drug,Qilu Hospital of Shandong University,Jinan 250012,China

出　　处：《World Journal of Emergency Medicine》2024年第3期181-189,共9页世界急诊医学杂志（英文）

基　　金：supported by grants from the National Natural Science Foundation of China (82370378 and 82070388);Taishan Scholar Program of Shandong Province (tsqn202211310);National Natural Science Foundation of Shandong Province (ZR2020MH035)。

摘　　要：BACKGROUND:This meta-analysis aimed to assess the efficacy of high-dose glucose-insulinpotassium(GIK) therapy on clinical outcomes in acute coronary syndrome(ACS) patients receiving reperfusion therapy.METHODS:We searched the PubMed,Web of Science,MEDLINE,Embase,and Cochrane Library databases from inception to April 26,2022,for randomized controlled trials(RCTs) that compared high-dose GIK and placebos in ACS patients receiving reperfusion therapy.The primary endpoint was major adverse cardiovascular events(MACEs).RESULTS:Eleven RCTs with 884 patients were ultimately included.Compared with placebos,high-dose GIK markedly reduced MACEs(risk ratio [RR] 0.57,95% confidence interval [95% CI]:0.35 to 0.94,P=0.03) and the risk of heart failure(RR 0.48,95% CI:0.25 to 0.95,P=0.04) and improved the left ventricular ejection fraction(LVEF)(mean difference [MD] 2.12,95% CI:0.40 to 3.92,P=0.02) at 6 months.However,no difference was observed in all-cause mortality at 30 d or 1 year.Additionally,high-dose GIK was significantly associated with increased incidences of phlebitis(RR 4.78,95% CI:1.36 to 16.76,P=0.01),hyperglycemia(RR 9.06,95% CI:1.74 to 47.29,P=0.009) and hypoglycemia(RR 6.50,95% CI:1.28 to 33.01,P=0.02) but not reinfarction,hyperkalemia or secondary reperfusion.In terms of oxidative stress-lowering function,high-dose GIK markedly reduced superoxide dismutase(SOD) activity but not glutathione peroxidase(GSH-Px) or catalase(CAT) activity.CONCLUSION:Patients with ACS receiving reperfusion therapy exhibited a reduction in MACEs and good oxidative stress-lowering eflcacy in response to high-dose GIK.Moreover,with a higher incidence of complications such as phlebitis,hyperglycemia,and hypoglycemia.Furthermore,there were no observed survival benefits associated with high-dose GIK.More trials with long-term follow-up are still needed.

关 键 词：Acute coronary syndrome HIGH-DOSE Glucose-insulin-potassium treatment Reperfusion therapy META-ANALYSIS 

分 类 号：R541.4[医药卫生—心血管疾病]