Glucose-Insulin-Potassium Therapy Guided by a Glucose-Controlled Insulin Infusion System in Acute Myocardial Infarction

A number of hormonal and metabolic alterations have been observed during acute myocardial infarction (AMI): There is a rapid increase of catecholamine and Cortisol secretion; free fatty acid (FFA) serum levels are markedly elevated (Gupta et al. 1969; Januszewicz et al. 1971; Vetter et al. 1974); and insulin secretion may be inappropiately low. These alterations result in a disturbance of glucose utilization, so-called stress hyperglycemia. Moreover, under these conditions and due to the accumulation of free fatty acids in the ischemic myocardium, severe ventricular arrhythmias as well as a progression of myocardial cell damage are likely to occur (Kurien and Oliver 1970; Kurien et al. 1971; Oliver et al. 1968).