This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Related articles  • Related letters  • Similar articles in JAMA  Topic Collections  • Nutritional and Metabolic Disorders  • Nutritional and Metabolic Disorders, Other  • Cardiovascular System  • Cardiovascular Disease/ Myocardial Infarction  • Drug Therapy  • Drug Therapy, Other  • Endocrine Diseases  • Diabetes Mellitus  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Glucose-Insulin-Potassium Therapy in Patients With ST-Segment Elevation Myocardial Infarction
Rafael Díaz, Abhinav Goyal, Shamir R. Mehta, Rizwan Afzal, Denis Xavier, Prem Pais, Susan Chrolavicius, Jun Zhu, Khawar Kazmi, Lisheng Liu, Andrzej Budaj, Mohammad Zubaid, Alvaro Avezum, Mikhail Ruda, and Salim Yusuf
JAMA. 2007;298(20):2399-2405.
ABSTRACT | FULL TEXT  

Diabetes and Mortality Following Acute Coronary Syndromes
Sean M. Donahoe, Garrick C. Stewart, Carolyn H. McCabe, Satishkumar Mohanavelu, Sabina A. Murphy, Christopher P. Cannon, and Elliott M. Antman
JAMA. 2007;298(7):765-775.
ABSTRACT | FULL TEXT  

Effect of Glucose-Insulin-Potassium Infusion on Mortality in Patients With Acute ST-Segment Elevation Myocardial Infarction: The CREATE-ECLA Randomized Controlled Trial
The CREATE-ECLA Trial Group Investigators*
JAMA. 2005;293(4):437-446.
ABSTRACT | FULL TEXT  

RELATED LETTERS

Glucose-Insulin-Potassium Therapy in Patients With STEMI
Lionel H. Opie
JAMA. 2008;299(20):2385-2386.
EXTRACT | FULL TEXT  

Glucose-Insulin-Potassium Therapy in Patients With STEMI
Rohit R. Arora and Srikanth Katragadda
JAMA. 2008;299(20):2386.
EXTRACT | FULL TEXT  

Glucose-Insulin-Potassium Therapy in Patients With STEMI
Ajay Chaudhuri, Richard Nesto, and Paresh Dandona
JAMA. 2008;299(20):2386-2387.
EXTRACT | FULL TEXT  

Glucose-Insulin-Potassium Therapy in Patients With STEMI—Reply
Abhinav Goyal, Rafael Díaz, and Shamir R. Mehta
JAMA. 2008;299(20):2387-2388.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Insulin therapy in acute coronary syndromes: an appraisal of completed and ongoing randomised trials with important clinical end points
Goyal et al.
Diabetes and Vascular Disease Research 2008;5:276-284.
ABSTRACT