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To the Editor: We have concerns about possible conclusions of the study of glucose-insulin-potassium (GIK) therapy in patients with ST-segment elevation myocardial infarction (STEMI) by Dr Díaz and colleagues,¹ which combined patients from the early-terminated OASIS-6 (Organization for the Assessment of Strategies for Ischemic Syndromes 6) trial with their previously published CREATE-ECLA Trial (Clinical Trial of Reviparin and Metabolic Modulation in Acute Myocardial Infarction Treatment and Evaluation–Estudios Clinicos Latino America).² In the earlier article, the investigators commented on a possible relationship between hyperglycemia and mortality. In a post hoc analysis in the study by Díaz et al,¹ there was again an association of higher glucose with greater event rates, consistent with the association of diabetes mellitus with elevated glucose and with worse acute myocardial infarction (MI) outcomes.³ We do not believe that an inference of a causal link between mortality and GIK is justified by these data.

The post hoc . . . [Full Text of this Article]

Harry P. Selker, MD, MSPH
hselker@tufts-nemc.org
Tufts-New England Medical Center
Boston, Massachusetts

Joanne Ingwall, PhD
Harvard Medical School
Boston

Charles E. Rackley, MD
Georgetown Medical Center
Washington, DC