Insights in Blood Pressure

Prospective Randomized Controlled Trial of Myocardial Protection by Activation of Preconditioning Mechanisms with Glucose-Insulin-Potassium or Ramipril in Patients Undergoing Coronary Intervention

Background: Preconditioning (PC) is triggered via additive parallel pathways. PTCA induced enzyme leak is a human preconditioning model correlating to outcome. We aim to test myocardial protection by Glucose-Insulin-Potassium (GIK) and Ramipril (ACEI) in humans.

Methods: 226 consecutive patients undergoing PTCA were randomized to groups 1 Ramipril 5mg (2.5mg if <50Kg). 2 GIK (30% glucose, 50 units actrapid insulin, 80mmol potassium at 1.5 ml/Kg/Hr), 3 ACEI and GIK, and 4 placebo. Exclusions: age >70, creatinine > 200 mmol/l, rising troponin levels (tnt), and contraindications to ACEI/GIK. Tnt was taken at –6, 0, and + 12 hours.

Results: 226 patients aged 57.2 years with 79% males.

Author(s):

Dr. Eugene Brian Wu

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