{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:54:36Z","timestamp":1790646876062,"version":"4.1.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,3,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Laboratory studies demonstrate glucose\u2010insulin\u2010potassium (\n              <jats:styled-content style=\"fixed-case\">GIK<\/jats:styled-content>\n              ) as a potent cardioprotective intervention, but clinical trials have yielded mixed results, likely because of varying formulas and timing of\n              <jats:styled-content style=\"fixed-case\">GIK<\/jats:styled-content>\n              treatment and different clinical settings. This study sought to evaluate the effects of modified\n              <jats:styled-content style=\"fixed-case\">GIK<\/jats:styled-content>\n              regimen given perioperatively with an insulin\u2010glucose ratio of 1:3 in patients undergoing cardiopulmonary bypass surgery.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In this prospective, randomized, double\u2010blinded trial with 930 patients referred for cardiac surgery with\n              <jats:styled-content style=\"fixed-case\">cardiopulmonary bypass<\/jats:styled-content>\n              ,\n              <jats:styled-content style=\"fixed-case\">GIK<\/jats:styled-content>\n              (200 g\/L glucose, 66.7 U\/L insulin, and 80 mmol\/L\n              <jats:styled-content style=\"fixed-case\">KC<\/jats:styled-content>\n              l) or placebo treatment was administered intravenously at 1\n              <jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>\n              \/kg per hour 10 minutes before anesthesia and continuously for 12.5 hours. The primary outcome was the incidence of in\u2010hospital major adverse cardiac events including all\u2010cause death, low cardiac output syndrome, acute myocardial infarction, cardiac arrest with successful resuscitation, congestive heart failure, and arrhythmia.\n              <jats:styled-content style=\"fixed-case\">GIK<\/jats:styled-content>\n              therapy reduced the incidence of\n              <jats:styled-content style=\"fixed-case\">major adverse cardiac events<\/jats:styled-content>\n              and enhanced cardiac function recovery without increasing perioperative blood glucose compared with the control group. Mechanistically, this treatment resulted in increased glucose uptake and less lactate excretion calculated by the differences between arterial and coronary sinus, and increased phosphorylation of insulin receptor substrate\u20101 and protein kinase B in the hearts of\n              <jats:styled-content style=\"fixed-case\">GIK<\/jats:styled-content>\n              \u2010treated patients. Systemic blood lactate was also reduced in\n              <jats:styled-content style=\"fixed-case\">GIK<\/jats:styled-content>\n              \u2010treated patients during\n              <jats:styled-content style=\"fixed-case\">cardiopulmonary bypass<\/jats:styled-content>\n              surgery.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A modified\n              <jats:styled-content style=\"fixed-case\">GIK<\/jats:styled-content>\n              regimen administered perioperatively reduces the incidence of in\u2010hospital\n              <jats:styled-content style=\"fixed-case\">major adverse cardiac events<\/jats:styled-content>\n              in patients undergoing\n              <jats:styled-content style=\"fixed-case\">cardiopulmonary bypass<\/jats:styled-content>\n              surgery. These benefits are likely a result of enhanced systemic tissue perfusion and improved myocardial metabolism via activation of insulin signaling by\n              <jats:styled-content style=\"fixed-case\">GIK<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL: clinicaltrials.gov. Identifier:\n              <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n              01516138.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.012376","type":"journal-article","created":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T09:00:17Z","timestamp":1583830817000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Modified Glucose\u2010Insulin\u2010Potassium Regimen Provides Cardioprotection With Improved Tissue Perfusion in Patients Undergoing Cardiopulmonary Bypass Surgery"],"prefix":"10.1161","volume":"9","author":[{"given":"Kun","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery Fourth Military Medical University Xi'an, China"},{"name":"School of Aerospace Medicine Fourth Military Medical University Xi'an, China"},{"name":"Department of Thoracic Surgery Provincial Cancer Hospital of Shannxi Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ultrasonic Diagnosis Xijing Hospital Fourth Military Medical University Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Li","sequence":"additional","affiliation":[{"name":"School of Aerospace Medicine Fourth Military Medical University Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Fourth Military Medical University Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Fourth Military Medical University Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wensheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Fourth Military Medical University Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jincheng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Fourth Military Medical University Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Fourth Military Medical University Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Health Statistics and Fourth Military Medical University Xi'an, China"},{"name":"Department of Health Services Fourth Military Medical University Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin-Liang","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Thomas Jefferson University Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiqiang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Fourth Military Medical University Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinghua","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Fourth Military Medical University Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Gao","sequence":"additional","affiliation":[{"name":"School of Aerospace Medicine Fourth Military Medical University Xi'an, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.130625"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvq349"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181782335"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000012529.00367.0F"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.426"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.945170"},{"key":"e_1_3_1_8_2","first-page":"e20","article-title":"A meta\u2010analysis of glucose\u2010insulin\u2010potassium therapy for treatment of acute myocardial infarction","volume":"15","author":"Mamas MA","year":"2010","unstructured":"Mamas MA, Neyses L, Fath-Ordoubadi F. 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