Patients with acute myocardial infarction (AMI) and diabetes mellitus, as well as patients admitted with elevated blood glucose without known diabetes, have impaired outcome. Therefore intensive glucose-lowering therapy with insulin (IGL) has been proposed in diabetic or hyperglycaemic patients and has been shown to improve survival and reduce incidence of adverse events. The current manuscript...

BACKGROUND Diabetes mellitus (DM) is associated with poor outcome after surgery. The prevalence of DM in hospitalised patients is up to 40%, meaning that the anaesthesiologist will encounter a patient with DM in the operating room on a daily basis. Despite an abundance of published glucose lowering protocols and the known negative outcomes associated with perioperative hyperglycaemia in DM, the...

BACKGROUND Glucose-insulin-potassium (GIK) may improve cardiovascular performance after coronary artery bypass graft surgery (CABG). Our study investigated whether an infusion of GIK during elective CABG surgery in type II diabetic patient improved left ventricular performance. METHODS We measured left ventricular ejection fraction and troponin (Tn), a myofibrillar structural protein. In this...

Factors influencing the rate of 201T1 clearance from the myocardium have not been clearly defined. This study determined the effect of an intravenous infusion of glucose-insulin-potassium (GIK) on the net 201TI clearance rates from myocardium with and without initial 201T1 loading. Anesthetized open-chest dogs underwent 5 min of left anterior descending coronary artery occlusion and intravenous...

Introduction: There are many trials that used 201 thalliumglucose insulin potassium ( 201 Tl-GIK) as a radiopharmaceutical material to detect the myocardial cells viability which is an important step before taking the decision of revascularization procedure. These trials showed an improvement in the detection of the myocardial cells viability by more than 30%, in comparison to the traditional t...

Prof. Dr. Joachim Boldt, Abteilung für Anästhesiologie und operative Intensivmedizin, Justus-Liebig-Universität Gießen Klinikstraße 29, D-35392 Gießen (Germany) In 18-78% of patients undergoing coronary artery bypass grafting (CABG), evidence of myocardial ischemia is diagnosed after finishing cardiopulmonary bypass (CPB) [1-3]. In addition to various cardioplegic solutions, several pharmacolog...

BACKGROUND The clinical benefits of insulin previously observed in acute ST-segment-elevation myocardial infarction (STEMI) may be partially explained by an anti-inflammatory effect. We assessed this potential effect of insulin in STEMI patients treated with fibrinolytics. METHODS AND RESULTS Thirty-two patients receiving reteplase were randomly assigned infusions of either insulin at 2.5 U/h...

OBJECTIVE AND METHODS The aim of this study was to evaluate myocardial viability in patients after acute myocardial infarction (AMI). We compared 201Tl SPECT after 201Tl with GIK (10% glucose 250 ml, insulin 5 U and KCl 10 mEq) infusion (GIK-201Tl) with resting 201Tl and 99mTc-pyrophosphate (PYP) dual SPECT, positron emission computed tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) in 2...