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Glucose-Insulin-Potassium Therapy in Patients With STEMI—Reply

Abhinav Goyal, MD, MHS; Rafael Díaz, MD; Shamir R. Mehta, MD, MSc
JAMA. 2008;299(20):2385-2388. doi:10.1001/jama.299.20.jlt0528-e.
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In Reply: Dr Selker and colleagues, Dr Opie, and Drs Arora and Katragadda suggest that GIK infusion in acute MI is more likely to be beneficial when given before reperfusion therapy but that in our present study GIK was used primarily after reperfusion. However, we found no benefit of GIK therapy in any subgroup of interest (all of which were sizable given our total population of 22 943 patients), including those who underwent reperfusion therapy (n = 18 735), received primary PCI (n = 2626), underwent reperfusion after randomization (n = 10 041) so that GIK was administered before or concurrently with reperfusion therapy, or were enrolled in ECLA centers (n = 3798) (Figure).

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Figure. Death at 30 Days by Subgroup
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The size of the data markers indicates the relative sample size of the number of patients in the denominators for each of the analyses. Error bars indicate 95% confidence intervals (CIs). CREATE indicates Clinical Trial of Reviparin and Metabolic Modulation in Acute Myocardial Infarction Treatment and Evaluation; ECLA, Estudios Clinicos Latino America; GIK, glucose-insulin-potassium; MI, myocardial infarction; OASIS-6, Organization for the Assessment of Strategies for Ischemic Syndromes 6.



May 28, 2008
Lionel H. Opie, MD, DPhil
JAMA. 2008;299(20):2385-2388. doi:10.1001/jama.299.20.jlt0528-b.
May 28, 2008
Ajay Chaudhuri, MD; Richard Nesto, MD; Paresh Dandona, MD, PhD
JAMA. 2008;299(20):2385-2388. doi:10.1001/jama.299.20.jlt0528-d.
May 28, 2008
Rohit R. Arora, MD; Srikanth Katragadda, MD
JAMA. 2008;299(20):2385-2388. doi:10.1001/jama.299.20.jlt0528-c.
May 28, 2008
Harry P. Selker, MD, MSPH; Joanne Ingwall, PhD; Charles E. Rackley, MD
JAMA. 2008;299(20):2385-2388. doi:10.1001/jama.299.20.jlt0528-a.
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