Key result
Glucose-insulin-potassium infusion during CABG surgery significantly lowered postoperative troponin I levels at 6 and 12 hours compared to saline (P<0.001 and P=0.022, respectively).
Why the study?
To investigate the effectiveness of glucose-insulin and potassium (GIK) solution regarding myocardial protection evaluated by postoperative CKMB and cardiac troponin I levels.
Does glucose-insulin and potassium (GIK) infusion reduce postoperative CK-MB and troponin I levels in patients undergoing on-pump CABG surgery?
RCT (n=64)
randomized
Does glucose-insulin and potassium (GIK) infusion reduce postoperative CK-MB and troponin I levels in patients undergoing on-pump CABG surgery?
p-value: p=<0.001 and 0.022
GIK infusion during on-pump CABG significantly reduces postoperative cardiac biomarker release, suggesting attenuated myocardial ischemic injury.
Supports GIK infusion to limit myocardial injury in on-pump CABG; extends metabolic cardioprotection evidence in cardiac surgery.
Background: Sodi-Pallares and colleagues first time introduced use of glucose-insulin and potassium (GIK) solution for myocardial protection. They used this solution in patients with acute myocardial infarction and concluded that GIK solution limited electrocardiographic changes in these patients. Objective: To investigate the effectiveness of the GIK solution regarding myocardial protection evaluated by postoperative creatine kinase MB (CKMB) and cardiac troponin I levels. Method: In this prospective, randomized clinical trial, sixty-four patients were assigned into two groups: GIK group, in which glucose-insulin and potassium infusion were given during surgery, and non-GIK group in which only saline infusion was given during the procedure. Results: All CK-MB values were lower in the GIK group than the Non-GIK group in the postoperative period (6, 12 and 24 hours’ samples) with statistically significant results. Troponin values were lower in the GIK group versus the Non-GIK group after 6 and 12 hours with statistical significance (P < 0.001 and 0.022 respectively). Conclusion: The addition of GIK infusion throughout the operation to standard myocardial protective techniques in patients undergoing on-pump coronary artery bypass graft (CABG) surgery attenuates myocardial ischemic injury.
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El-Hakeem et al. (2021) conducted an RCT in Coronary revascularization (n=64). Glucose-insulin-potassium (GIK) infusion vs. Saline infusion was evaluated on Postoperative creatine kinase MB (CKMB) and cardiac troponin I levels (p=<0.001 and 0.022). Glucose-insulin-potassium infusion during CABG surgery significantly lowered postoperative troponin I levels at 6 and 12 hours compared to saline (P<0.001 and P=0.022, respectively).
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