Skip to main content
Erschienen in:

01.08.2023 | Current Opinion

An Opportune Time to Consider Glucose–Insulin–Potassium Therapy for Takotsubo Syndrome

verfasst von: John E. Madias

Erschienen in: American Journal of Cardiovascular Drugs | Ausgabe 5/2023

Einloggen, um Zugang zu erhalten

Abstract

This viewpoint takes the position that the management of takotsubo syndrome (TTS) should not wait the elucidation of the pathophysiology of this mysterious malady but should move along the direction currently implemented for acute coronary syndromes (ACS). Accordingly, and since there is a current rekindled interest in the salutary effect of glucose–insulin–potassium (GIK) for the management of acute myocardial infarction, and in general of the broad domain of ACS, it is the opinion of this author that it is an opportune time for the same therapeutic principles, including GIK, applied for the broad domain of suspected ACS (in view of the prospective phase 3 IMMEDIATE-2 trial), to be considered for TTS.
Literatur
2.
Zurück zum Zitat Madias JE. Insulin and takotsubo syndrome: plausible pathophysiologic, diagnostic, prognostic, and therapeutic roles. Acta Diabetol. 2021;58:989–96.CrossRefPubMed Madias JE. Insulin and takotsubo syndrome: plausible pathophysiologic, diagnostic, prognostic, and therapeutic roles. Acta Diabetol. 2021;58:989–96.CrossRefPubMed
3.
Zurück zum Zitat Madias JE. Insulin and short acting iv beta blockers: a “new” proposal for the acute management of takotsubo syndrome. Int J Cardiol. 2021;334:18–20.CrossRefPubMed Madias JE. Insulin and short acting iv beta blockers: a “new” proposal for the acute management of takotsubo syndrome. Int J Cardiol. 2021;334:18–20.CrossRefPubMed
4.
Zurück zum Zitat Udelson JE, Selker HP, Braunwald E. Glucose-insulin-potassium therapy for acute myocardial infarction: 50 years on and time for a relook. Circulation. 2022;146:503–5.CrossRefPubMed Udelson JE, Selker HP, Braunwald E. Glucose-insulin-potassium therapy for acute myocardial infarction: 50 years on and time for a relook. Circulation. 2022;146:503–5.CrossRefPubMed
5.
Zurück zum Zitat Maroko PR, Libby P, Sobel BE, et al. Effect of glucose-insulin-potassium infusion on myocardial infarction following experimental coronary artery occlusion. Circulation. 1972;45:1160–75.CrossRefPubMed Maroko PR, Libby P, Sobel BE, et al. Effect of glucose-insulin-potassium infusion on myocardial infarction following experimental coronary artery occlusion. Circulation. 1972;45:1160–75.CrossRefPubMed
6.
Zurück zum Zitat Madias JE, Venkataraman K, Hodd WB Jr. Precordial ST-segment mapping. 1. Clinical studies in the coronary care unit. Circulation. 1975;52:799–809.CrossRefPubMed Madias JE, Venkataraman K, Hodd WB Jr. Precordial ST-segment mapping. 1. Clinical studies in the coronary care unit. Circulation. 1975;52:799–809.CrossRefPubMed
7.
Zurück zum Zitat Madias JE, Madias NE, Hood WB Jr. Precordial ST-segment mapping. 2. Effects of oxygen inhalation on ischemic injury in patients with acute myocardial infarction. Circulation. 1976;53:411–7.CrossRefPubMed Madias JE, Madias NE, Hood WB Jr. Precordial ST-segment mapping. 2. Effects of oxygen inhalation on ischemic injury in patients with acute myocardial infarction. Circulation. 1976;53:411–7.CrossRefPubMed
8.
Zurück zum Zitat Madias JE, Hood WB Jr. Effects of methylprednisolone on the ischemic damage in patients with acute myocardial infarction. Circulation. 1982;65:1106–13.CrossRefPubMed Madias JE, Hood WB Jr. Effects of methylprednisolone on the ischemic damage in patients with acute myocardial infarction. Circulation. 1982;65:1106–13.CrossRefPubMed
9.
Zurück zum Zitat Stone GW, Selker HP, Thiele H, et al. Relationship between infarct size and outcomes following primary PCI: patient-level analysis from 10 randomized Trials. J Am Coll Cardiol. 2016;57:1674–83.CrossRef Stone GW, Selker HP, Thiele H, et al. Relationship between infarct size and outcomes following primary PCI: patient-level analysis from 10 randomized Trials. J Am Coll Cardiol. 2016;57:1674–83.CrossRef
10.
Zurück zum Zitat Selker HP, Udelson JE, Ruthazer R, et al. Relationship between therapeutic effects on infarct size in acute myocardial infarction and therapeutic effects on one-year outcomes: a patient-level analysis of randomized clinical trials. Am Heart J. 2017;188:18–25.CrossRefPubMed Selker HP, Udelson JE, Ruthazer R, et al. Relationship between therapeutic effects on infarct size in acute myocardial infarction and therapeutic effects on one-year outcomes: a patient-level analysis of randomized clinical trials. Am Heart J. 2017;188:18–25.CrossRefPubMed
11.
Zurück zum Zitat Sullivan AL, Beshansky JR, Ruthazer R. Factors associated with longer time to treatment for patients with suspected acute coronary syndromes. Circ Cardiovasc Qual Outcomes. 2014;7:86–94.CrossRefPubMedPubMedCentral Sullivan AL, Beshansky JR, Ruthazer R. Factors associated with longer time to treatment for patients with suspected acute coronary syndromes. Circ Cardiovasc Qual Outcomes. 2014;7:86–94.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Menees DS, Peterson ED, Wang Y, et al. Door-to-balloon time and mortality among patients undergoing primary PCI. N Engl J Med. 2013;369:901–9.CrossRefPubMed Menees DS, Peterson ED, Wang Y, et al. Door-to-balloon time and mortality among patients undergoing primary PCI. N Engl J Med. 2013;369:901–9.CrossRefPubMed
13.
Zurück zum Zitat Grossman AN, Opie LH, Beshansky JR, et al. Glucose-insulin-potassium revived: current status in acute coronary syndromes and the energy-depleted heart. Circulation. 2013;127:1040–8.CrossRefPubMed Grossman AN, Opie LH, Beshansky JR, et al. Glucose-insulin-potassium revived: current status in acute coronary syndromes and the energy-depleted heart. Circulation. 2013;127:1040–8.CrossRefPubMed
14.
Zurück zum Zitat Selker HP, Beshansky JR, Sheehan PR, et al. Effect of out-of-hospital administration of intravenous glucose, insulin, and potassium (GIK) in patients with suspected acute coronary syndromes: the IMMEDIATE randomized controlled trial. JAMA. 2012;307:1925–33.CrossRefPubMedPubMedCentral Selker HP, Beshansky JR, Sheehan PR, et al. Effect of out-of-hospital administration of intravenous glucose, insulin, and potassium (GIK) in patients with suspected acute coronary syndromes: the IMMEDIATE randomized controlled trial. JAMA. 2012;307:1925–33.CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Selker HP, Udelson JE, Massaro JM, et al. One-year outcomes of out-of-hospital administration of intravenous glucose, insulin and potassium (GIK) in patients with suspected acute coronary syndrome in the IMMEDIATE (Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency care) trial. Am J Cardiol. 2014;113:1599–605.CrossRefPubMedPubMedCentral Selker HP, Udelson JE, Massaro JM, et al. One-year outcomes of out-of-hospital administration of intravenous glucose, insulin and potassium (GIK) in patients with suspected acute coronary syndrome in the IMMEDIATE (Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency care) trial. Am J Cardiol. 2014;113:1599–605.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Selker HP, Harris WS, Rackley CE, et al. Very early administration of glucose-Insulin-potassium (GIK) by emergency medical service for acute coronary syndromes: biological mechanisms for benefit in the IMMEDIATE trial. Amer Heart J. 2016;178:168–75.CrossRefPubMed Selker HP, Harris WS, Rackley CE, et al. Very early administration of glucose-Insulin-potassium (GIK) by emergency medical service for acute coronary syndromes: biological mechanisms for benefit in the IMMEDIATE trial. Amer Heart J. 2016;178:168–75.CrossRefPubMed
17.
Zurück zum Zitat Ellis KL, Zhou Y, Rodriguez-Murillo L, et al. Common variants associated with changes in levels of circulating free fatty acids after administration of glucose-insulin-potassium (GIK) therapy in the IMMEDIATE trial. Pharmacogenom J. 2017;17:76–83.CrossRef Ellis KL, Zhou Y, Rodriguez-Murillo L, et al. Common variants associated with changes in levels of circulating free fatty acids after administration of glucose-insulin-potassium (GIK) therapy in the IMMEDIATE trial. Pharmacogenom J. 2017;17:76–83.CrossRef
18.
Zurück zum Zitat Ray M, Ruthazer R, Beshansky JR, et al. A predictive model to identify patients with suspected acute coronary syndromes at high risk of cardiac arrest or in-hospital mortality: an IMMEDIATE Trial sub-study. Int J Cardiol Heart Vasc. 2015;9:37–42.PubMedPubMedCentral Ray M, Ruthazer R, Beshansky JR, et al. A predictive model to identify patients with suspected acute coronary syndromes at high risk of cardiac arrest or in-hospital mortality: an IMMEDIATE Trial sub-study. Int J Cardiol Heart Vasc. 2015;9:37–42.PubMedPubMedCentral
19.
Zurück zum Zitat Omerovic E, James S, Erlinge D, et al. Rationale and design of BROKEN-SWEDEHEART: a registry-based, randomized, parallel, open-label multicenter trial to test pharmacological treatments for broken heart (takotsubo) syndrome. Am Heart J. 2022;257:33–40.CrossRefPubMed Omerovic E, James S, Erlinge D, et al. Rationale and design of BROKEN-SWEDEHEART: a registry-based, randomized, parallel, open-label multicenter trial to test pharmacological treatments for broken heart (takotsubo) syndrome. Am Heart J. 2022;257:33–40.CrossRefPubMed
20.
Zurück zum Zitat Madias JE. Some inquiries about the currently launched BROKEN SWEDEHEART therapeutic trial for takotsubo syndrome. Am Heart J. 2023;258:190–1.CrossRefPubMed Madias JE. Some inquiries about the currently launched BROKEN SWEDEHEART therapeutic trial for takotsubo syndrome. Am Heart J. 2023;258:190–1.CrossRefPubMed
21.
Zurück zum Zitat Braunwald E, Kloner RA. The stunned myocardium: prolonged, postischemic ventricular dysfunction. Circulation. 1982;66:1146–9.CrossRefPubMed Braunwald E, Kloner RA. The stunned myocardium: prolonged, postischemic ventricular dysfunction. Circulation. 1982;66:1146–9.CrossRefPubMed
22.
Zurück zum Zitat Beshansky JR, Sheehan PR, Klima KJ, et al. A community consultation survey to evaluate support for and success of the IMMEDIATE trial. Clin Trials. 2014;11:178–86.CrossRefPubMedPubMedCentral Beshansky JR, Sheehan PR, Klima KJ, et al. A community consultation survey to evaluate support for and success of the IMMEDIATE trial. Clin Trials. 2014;11:178–86.CrossRefPubMedPubMedCentral
Metadaten
Titel
An Opportune Time to Consider Glucose–Insulin–Potassium Therapy for Takotsubo Syndrome
verfasst von
John E. Madias
Publikationsdatum
01.08.2023
Verlag
Springer International Publishing
Erschienen in
American Journal of Cardiovascular Drugs / Ausgabe 5/2023
Print ISSN: 1175-3277
Elektronische ISSN: 1179-187X
DOI
https://doi.org/10.1007/s40256-023-00597-2

Kompaktes Leitlinien-Wissen Innere Medizin (Link öffnet in neuem Fenster)

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Neu im Fachgebiet Kardiologie

Extrakorporale Reanimation: Wechsel des EKG-Musters verschlechtert Prognose

Patientinnen und Patienten im Herzstillstand mit schockbarem Rhythmus, deren EKG-Muster sich später ändert, haben schlechtere Chancen. Eine Studiengruppe hat die Bedeutung eines solchen Rhythmuswechsels mit Blick auf die extrakorporale Reanimation genauer untersucht.

Leben retten dank Erste-Hilfe-App

Bei einem Herzstillstand zählt jede Minute bis eine Reanimation begonnen wird. Notfallmediziner Prof. Dr. med. Michael Müller erklärt im Interview, wie medizinisch geschulte Ersthelfende mittels App alarmiert werden können – und warum digitale Lösungen die Notfallversorgung revolutionieren könnten.

Kawasaki-Syndrom: Kein ASS mehr in der Akutphase?

Um Kinder mit Kawasaki-Syndrom vor entzündlich bedingten Veränderungen der Koronarien zu bewahren, werden sie in der Akutphase mit intravenösen Immunglobulinen und hochdosierter Acetylsalicylsäure (ASS) behandelt. Neuesten Daten zufolge könnte womöglich auf ASS verzichtet werden.

Podcast

Eier, Kaffee und Statine: Mythen und Fakten zur kardiovaskulären Prävention

Deutschland liegt bei der Lebenserwartung im westeuropäischen Vergleich hinten. Insbesondere kardiovaskulär bedingte Erkrankungen sind Todesursache Nr. 1. Was machen andere Länder besser? Sie setzen in der Prävention früher an und behandeln nicht erst, wenn es zu spät ist, sagt die Lipidologin Dr. Katrin Gebauer. Im Podcast erklärt sie, wo sie hier noch Nachholbedarf sieht und welche Faktoren sich gezielt beeinflussen lassen.

EKG Essentials: EKG befunden mit System (Link öffnet in neuem Fenster)

In diesem CME-Kurs können Sie Ihr Wissen zur EKG-Befundung anhand von zwölf Video-Tutorials auffrischen und 10 CME-Punkte sammeln.
Praxisnah, relevant und mit vielen Tipps & Tricks vom Profi.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.