Document Type : Original Article(s)

Authors

1 Associate Professor , Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

2 Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

3 Assistant Professor, Isfahan Kidney Diseases Research Center, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Professor, Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

5 Assistant Professor, Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

6 Assistant Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

BACKGROUND: Despite conventional treatment methods of acute myocardial infarction, its complications and mortality rates are still very high. Finding new cost-effective treatments like regulation of ischemic muscle metabolism at the time of thrombolytic therapy can meet this requirement to some extent. This study investigated the efficacy of the pharmaceutical combination of glucose, insulin, potassium (GIK) and magnesium along with thrombolytic therapy.METHODS: In a double-blind, controlled clinical trial, 200 patients with acute myocardial infarction who had the indication for thrombolytic treatment were selected and divided to 6 groups of almost 30 people. A specific treatment protocol was designed for each group. The patients in the first 5 groups were compared with the ones in the sixth group as the control group in terms of frequency of complications and in-hospital mortality and also mortality during 3 and 6 months after the treatment.RESULTS: Mean age of the patients was 58.77 ± 2.6 years. Males constituted 77% of the study population. Heart failure, in-hospital arrhythmia and ejection fraction (EF) at discharge showed favorable results in the five groups which received metabolic regulations as compared to the control group. In-hospital mortality of no groups was different from that of the control group (P > 0.05). Three months after the treatment, mortality of the group that received GIK and magnesium was lower than that of the control group (P < 0.05). After 6 months, none of the patients who received high-dose GIK and magnesium along with thrombolytic therapy died while the mortality rate of the control group was 44.4% (P < 0.05).CONCLUSION: The infusion of GIK and magnesium solution along with thrombolytic therapy can lead to a decrease in the long-term mortality and complications in patients with acute myocardial infarction.Keywords: Acute Myocardial Infarction, Glucose, Insulin, Potassium, Magnesium, Thrombolytic Therapy, Cardiovascular Diseases, Clinical Trial