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May 9, 2012

A New Look at an Old Therapy

Author Affiliations

Author Affiliations: Duke Translational Medicine Institute, Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.

JAMA. 2012;307(18):1972-1973. doi:10.1001/jama.2012.4434

Despite major advances in the care of patients with acute coronary syndrome over the past 3 decades, rates of early morbidity and mortality associated with this condition remain unacceptably high. In the 1980s, the concept of administering glucose, insulin, and potassium (GIK) to patients with suspected myocardial ischemia garnered substantial interest in both the research and practice communities. The therapy is remarkably simple and available globally at a low cost—an especially attractive feature given the increasing incidence of cardiovascular disease in low-income countries.1 The results of several clinical trials of moderate size seemed to suggest a bright future for GIK therapy24; however, a subsequent large pragmatic trial found no benefit,5 and discussion of the treatment subsided.

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