Pilot Heart Attack Therapy Improves Survival

Glucose insulin and potassium mix reduce death and cardiac arrest in heart attack patients

(RxWiki News) An inexpensive treatment administered by paramedics could significantly improve survival of heart attack patients. The simple mix of glucose, insulin and potassium could reduce chances of cardiac arrest or dying by 50 percent.

The effect was even more significant for patients suffering ST-elevation heart attacks, in which a coronary artery is completely obstructed. The treatment, which costs only $50, could reduce their chance of cardiac arrest or death by 60 percent.

"Call 9-1-1 immediately for heart attack symptoms."

Dr. Harry P. Selker, executive director of the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center and co-leader of the study, noted that when the treatment is given immediately in the home or on the way to the hospital -- even if it is before a diagnosis is established -- the mixture appears to cut the size of heart attacks and reduce by half the risk of cardiac arrest or death.

He said the treatment appears to have promise in reducing deaths from acute coronary syndromes, which indicates that a heart attack is underway or imminent. The treatment, however, will not prevent the heart attack from occurring.

During the IMMEDIATE trial, researchers trained paramedics in three dozen emergency medical services systems in 13 U.S. cities to administer the mixture of glucose, insulin and potassium when a patient was likely having a heart attack or was near having one.

The paramedics used electrocardiograph-based ACI-TIPI (acute cardiac ischemia time-insensitive predictive instrument) and thrombolytic predictive instrument decision support, which prints patient predictions at the top of an electrocardiogram. The medics then used this to decide if a patient could benefit from the treatment. During the study 911 patients received either the treatment or a placebo.

They found that the mixture helped save heart tissue, with 2 percent of heart tissue destroyed in patients who received the treatment compared to 10 percent in the placebo group. Over the initial month alone, patients who received the treatment were found 40 percent less likely to die, have cardiac arrest or be hospitalized for heart failure.

About 23 percent of patients who received the treatment were later determined to be false alarms, however, the treatment did not appear to cause harmful effects in these patients.

“We wanted to do something that is effective and can be used anywhere,” said Dr. Selker. “We’ve done a lot of studies of acute cardiac care in emergency departments and hospitals, but more people die of heart attacks outside the hospital than inside the hospital. Hundreds of thousands of people per year are dying out in the community; we wanted to direct our attention to those patients.”

Investigators are following participants, checking in at six months and 12 months, to evaluate possible longer term benefits of the treatment.

This study, which was funded by the National Institute of Health’s National Heart, Lung and Blood Institute, was presented Tuesday at the American College of Cardiology's annual scientific sessions.

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Review Date: 
March 27, 2012