Heart Attack Treatment Saves Lives
Rarely Used, Inexpensive Treatment Has Been Available for Decades
Sept. 2, 2003 -- An inexpensive and low-tech heart attack treatment that has been around for decades has the potential to save thousands of lives each year, new research from the Netherlands suggests.
In the largest study yet to examine the heart attack treatment, death rates fell by almost three-fourths among patients who had a heart attack but did not have subsequent heart failure. The treatment involves giving a glucose-insulin-potassium solution in the hours following a heart attack.
"I consider this to be a landmark study for the treatment of [heart attacks]," writes Boston University School of Medicine cardiologist Carl S. Apstein, MD, who was not involved with the research but wrote an editorial accompanying it. It has the potential to save approximately 30,000 lives per year, he writes.
It is not clear why the simple heart attack treatment saves lives, but researchers believe that glucose provides most of the heart-protecting benefit, with the insulin and potassium helping it get to the heart muscle. Glucose is the sugar that most cells in the body use for fuel.
The study included 940 heart attack patients in the Netherlands. Half the patients were given the continuous glucose-insulin-potassium infusion for eight to 12 hours and the other half did not receive the heart attack treatment. If needed, the patients also received angioplasty -- using a balloon to open the clogged artery that caused the heart attack.
At first, the researchers did not see any evidence that the heart attack treatment improved survival chances. But when the 84 patients with signs of heart failure from the heart attack were removed from the analysis, a clear survival benefit emerged for the remaining 856 patients who received infusions.
Thirty days after the heart attack treatment, the death rate was almost 75% lower among infusion patients -- 1.2% vs. 4.2% for patients who did not receive infusions. The infusion patients also had fewer repeat heart attacks and repeat angioplasties. The findings are reported in the Sept. 3 issue of the Journal of theAmerican College of Cardiology.