European Heart Journal Advance Access originally published online on March 9, 2005
European Heart Journal 2005 26(7):639-641; doi:10.1093/eurheartj/ehi232
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org
Insulin vs. strict blood glucose control to achieve a survival benefit after AMI?
Department of Intensive Care Medicine, Catholic University of Leuven, B-3000 Leuven, Belgium
* Corresponding author. Tel: +32 16 34 4021; fax: +32 16 34 4015. E-mail address: greta.vandenberghe@uz.kuleuven.ac.be
This editorial refers to ‘Intense metabolic control by means of insulin in patients with diabetes mellitus and acute myocardial infarction (DIGAMI 2): effects on morbidity and mortality’
by K. Malmberg et al., on page 650
| The first 150 words of the full text of this article appear below. |
Patients with diabetes mellitus have a 1.5–2 times higher risk of death after myocardial infarction than do non-diabetic patients. In diabetic myocardium, the consumption of fatty acid as metabolic fuel is thought to be increased, whereas glycolysis is impaired both in ischaemic and non-ischaemic areas. As the consumption of fatty acids instead of glucose requires more oxygen, such a shift may be deleterious particularly when oxygen supply is limited. More than four decades ago, the concept of infusing glucose together with insulin and potassium (GIK) to protect the ischaemic myocardium was introduced.1 Early clinical studies on the effect of such a ‘metabolic cocktail’ yielded promising results suggesting that GIK might be a way to reduce morbidity and early mortality in patients with an acute myocardial infarction (AMI). As the possible mechanism behind a cardioprotective effect of GIK, Opie2 proposed the promotion of glycolysis in cardiomyocytes and the diversion of fatty
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Related articles in EHJ:
- Intense metabolic control by means of insulin in patients with diabetes mellitus and acute myocardial infarction (DIGAMI 2): effects on mortality and morbidity
- K. Malmberg, L. Rydén, H. Wedel, K. Birkeland, A. Bootsma, K. Dickstein, S. Efendic, M. Fisher, A. Hamsten, J. Herlitz, P. Hildebrandt, K. MacLeod, M. Laakso, C. Torp-Pedersen, A. Waldenström, and for the DIGAMI 2 Investigators
EHJ 2005 26: 650-661.[Abstract] [FREE Full Text]
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