Simple treatment claimed effective for heart attacks Poorly designed tests blocked it for 30 years, Latin researchers say

November 24, 1998|By LOS ANGELES TIMES

A simple, inexpensive treatment that could be used successfully by low-technology hospitals worldwide can dramatically reduce the number of deaths caused by heart attacks, researchers report today.

In the United States, the treatment, which involves giving the patient a mixture of sugar, insulin and potassium to nourish heart muscles deprived of oxygen by a heart attack, might prevent about 75,000 heart attacks a year, the new research indicates.

The treatment was first devised in the 1960s, but was then discarded because poorly conducted clinical tests led doctors to doubt that it worked.

But a new study by a team of researchers from six Latin American countries reported in Circulation: Journal of the American Heart Association indicates the earlier doubts were ill-founded.

In a pilot trial involving 407 people who had a heart attack, the use of the treatment, called GIK -- for glucose, insulin and potassium (for which K is the chemical symbol) -- reduced the overall death rate by half.

In patients who either received a clot-busting drug or underwent angioplasty to open clogged arteries, the use of GIK reduced the death rate from 15.2 percent to 5.2 percent.

An estimated 1.1 million Americans have a heart attack each year and about a third of them die.

The trial is "a landmark study," said Dr. Carl S. Apstein of the Boston University School of Medicine. "The decrease in death rate is dramatic: the largest reduction of just about any intervention that has been tried."

The GIK treatment was first reported in 1962 as a way to provide energy for the heart muscle during and immediately after a heart attack, when some tissue is not receiving oxygen because of reduced blood flow. Glucose can be used by heart tissue without oxygen. Insulin and potassium increase the muscle's ability to take up the glucose.

The combination also reduces the harmful high concentrations of free fatty acids that are present during the acute phase of a heart attack.

For a decade, some physicians continued to use GIK, but clinical studies came to conflicting conclusions about its effectiveness.

Some researchers continued to study its use in animals, however, and "it very consistently showed a protective effect," Apstein said.

Pub Date: 11/24/98

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