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1.
Cardiovasc Drugs Ther ; 13(3): 191-200, 1999 May.
Article En | MEDLINE | ID: mdl-10439881

We aimed to assess the clinical efficacy of glucose-insulin-potassium (GIK) in acute myocardial infarction. Experimental data provided evidence of the beneficial effects of GIK on ischemic myocardium. The clinical trials, mostly uncontrolled and conducted mainly before the thrombolytic era, were inconclusive due to the small number of patients and discrepancies in protocols. In order to evaluate the efficacy of this intervention, we have performed a prospective multicenter randomized study. The study consisted of 954 patients with acute myocardial infarction (MI) randomized within 24 hours from the onset of symptoms to low-dose GIK (n = 494), which consisted of 1000 mL 10% dextrose, 32-20 U insulin, and 80 mEq K-, or to the control group (n = 460), which was given 1000 mL 0.89% sodium chloride, by intravenous 24-hour infusion at a rate of 42 mL/h. Cardiac mortality and the occurrence of cardiac events at 35 days did not differ between GIK and control-allocated patients (32 (6.5%) vs. 21 (4.6%), respectively; OR 1.45, 95% CI 0.79-2.68, P = 0.20; and 214 (43.3%) vs. 192 (41.7%), OR 1.07, 95% CI 0.82-1.38, P = 0.62). Total mortality at 35 days was significantly higher in the GIK than in the control group (44 (8.9%) vs. 22 (4.8%), respectively, OR 1.95, 95% CI 1.12-3.47, P = 0.01). The excess of non-cardiac deaths in the GIK group may have occurred by chance. Low-dose GIK treatment does not improve the survival and clinical course in acute MI.


Cardioplegic Solutions/therapeutic use , Myocardial Infarction/drug therapy , Aged , Cardioplegic Solutions/administration & dosage , Drug Therapy, Combination , Female , Glucose/administration & dosage , Glucose/therapeutic use , Humans , Infusions, Intravenous , Insulin/administration & dosage , Insulin/therapeutic use , Male , Middle Aged , Myocardial Infarction/mortality , Poland , Potassium/administration & dosage , Potassium/therapeutic use , Prospective Studies , Treatment Outcome
2.
Pol Arch Med Wewn ; 101(5): 413-8, 1999 May.
Article Pl | MEDLINE | ID: mdl-10740421

Atrial fibrillation (AF) is the most common arrhythmia occurring in clinical practice. It is the most frequent cause of hospitalization in cardiac rhythm disturbance. Despite comprehensive progress in the research into electrophysiological mechanisms leading to this loss of normal rhythm and new procedures dealing with it, the main problem being the conversion to and maintaining the normal sinus rhythm (SR) has not been solved. The polish study "Hot Cafe" is trying to evaluate the advantages and risks of the two procedures widely used in clinical practice in patients (pts) with chronic AF, i.e. conversion and maintaining SR vs leaving pts with the arrhythmia. Pts with non-valvular chronic AF fulfilling the criteria for including them into the sample are randomly assigned to two procedures: conversion to SR by means of direct current cardioversion and maintaining it or leaving pts with AF. Pts left with AF are treated by rate control and antithrombotic treatment. The project is of prospective kind and it will be carried out by many medical institutions. It is planned to include 200 pts. The observation period will last at least 12 months. Preliminary results after inclusion of the first 121 pts are shown.


Atrial Fibrillation/therapy , Aged , Amiodarone/administration & dosage , Anti-Arrhythmia Agents/administration & dosage , Anticoagulants , Chronic Disease , Dicumarol/therapeutic use , Electric Countershock , Female , Humans , Male , Middle Aged , Premedication , Prospective Studies
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