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Ann Thorac Surg 2002;73:1251-1252
© 2002 The Society of Thoracic Surgeons

Invited commentary

Harold L. Lazar, MDa

a Department of Cardiothoracic Surgery, Boston University School of Medicine, Boston Medical Center, 88 Newton St, Suite B404, Boston, MA 02118 USA

e-mail: harold.lazar@bmc.org

In their study, the authors concluded that the infusion of glucose-insulin-potassium (GIK) causes insulin resistent hyperglycemia in elective off-pump coronary artery bypass (OPCAB) patients with no demonstrable benefit. However, these results reflect major flaws in the design of the study and the manner in which GIK was delivered.

The overall incidence of myocardial necrosis was especially high in this group of patients. The release of tropinin was 27 to 100 times higher than reported by Ascione and Bonatti and the infarct rate was 8 and 20 times higher than described by Bouchard [6] and Ascione [5]. New Q-waves developed in 8 patients, however there was no correlation between the appearance of new Q-waves and isoenzyme release. In fact, cardiac index actually improved as troponin release increased; yet, mixed venous oxygen saturation (SV. . . [Full Text of this Article]


Related Article

Glucose-insulin-potassium infusion for myocardial protection during off-pump coronary artery surgery
William A. Lell, Vance G. Nielsen, David C. McGiffin, Frank E. Schmidt, Jr, James K. Kirklin, and Alfred W. Stanley, Jr
Ann. Thorac. Surg. 2002 73: 1246-1251. [Abstract] [Full Text] [PDF]



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