Metabolic interventions in acute myocardial infarction

This thesis is a new branch on the large tree of studies on optimal therapeutic strategy for and understanding of ST segment elevation MI. In 1989, the Zwolle Myocardial Infarction Study Group performed its first study of comparing PCI with streptokinase. Thereafter studies on the effect of primary PCI, stenting, intra-aortic balloon counterpulsation, prehospital treatment with heparin and glycoprotein IIb/IIIa receptor blockers have been reported. Over the last years more research has been done to investigate the causative mechanisms behind favorable and unfavorable outcome after treatment with primary PCI. Currently, special emphasis is given to the effect of glucose derangements and patients with diabetes mellitus. The concept to add a metabolic intervention to the treatment strategy of primary PCI was formulated in 1997. The purpose of this thesis is to investigate the effect of metabolic interventions and disturbances on the clinical outcome and myocardial function in ST segment elevation MI patients