ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology
Glucose-Insulin-Potassium Therapy and its Effects on Signal-averaged Electrocardiography in Acute Myocardial Infarction [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2000; 28(3): 161-167

Glucose-Insulin-Potassium Therapy and its Effects on Signal-averaged Electrocardiography in Acute Myocardial Infarction

Mehmet Sıddık ÜLGEN1, Kenan İLTİMUR1, A. Aziz KARADEDE1, Sait ALAN1, Nizamettin TOPRAK1

Low amplitude signals (LP) at the end of the QRS in patients with acute myocardial infaretion CAMI) are related to fragmentation of the electrical impulse in ventricular myocardium and detected on signalaveraged electrocardiography. In this study, w e investigated the use of glucose-insulin-potassium (GlK) solution and its effects on the SAECG in AMI.
METHODS
Seventy-two consec utive patients diagnosed with first Q-wave AMI were prospectively studied. Thrombolytic therapy was given to all patients unless contraindicated. The patients were randomly given glucose-insulin-potassium (GlK, n=34) solutions which consisted of 300 g of glucose, 50 units of insulin and 80 mEq of KCl in 1000 cc water placebo (saline, n.38). Ambulatory electrocardiographic examinations were performed in all patients between 24-48th hours. S ub-maxi ınal exercise testing (if not contraindicated), s ignalaveraged e lectrocardiogram (SAECG) and echocardiographic records were obtained before discharge (6-9, mean 7 days). In postdischarge early period (in 30-40 days after index infarction) SAECG and echocardiography recordings were repeated.
RESULTS
There were no differences found between both groups in view of ages, number of risk factors, Iocalization of infarction. In pre-di sc harge evaluations total filtered QRS durat ion (FQRS ı: ı 03±7 msec vs I 08± ı ı msec p<0.05), Iow-amplitude terminal signal d uration (HFLA ı: 25±8 msec vs 32±1 I msec, p0.05) were found to be lower while RMS-40ı (47±2ı vs 33± ı 9 p<0.05) and EFı (59± ıo vs 52±1 1, p<0.05) were higher in the GİK compared with the placebo group. The ineidence of post-MI angina pectoris was significantly lower in the GIK-administered group (p<0.005) than in the placebo groups. The ineidence of premature ventriu lar contraction was insignifiantly lower in the GIK-administrated group (p>0.05). We concluded that using GlK solutions at the early stages of AMI may be beneficial on the SAECG, angina incidence, and left ventricular systolic performance in the pre-and postdischarge early period of AMI.



Manuscript Language: Turkish
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Journal Citation Indicator: 0.18
CiteScore: 1.1
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