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By mid-2010, an international clinical trial now underway may conclusively confirm insulin's ability to limit damage from heart attacks. The trial, called INTENSIVE, will be conducted at 90 centers in the United States, Canada, Brazil and Argentina.
Scientists are currently recruiting 600 patients who fit the trial's research criteria. Once they are recruited, says Paresh Dandona, MD, PhD at the University of Buffalo School of Medicine and Biomedical Sciences, it will take as little as a month to determine the usefulness of insulin (including Lantus) in limiting damage to the heart.
"The follow-up will be swift," says Dr. Dandona, who is heading the international trial. "We'll look to see if the insulin reduces the size and severity of an infarct - something that we will know within 30 days."
What Dr. Dandona and his colleagues are looking to prove is insulin's ability to reduce the cardiovascular inflammation that typically shows up after a heart attack. "Many heart patients' glucose levels are high, and higher glucose makes them run a greater risk of mortality from inflammation," he says. "Insulin neutralizes inflammation, which is a partial cause of post-heart attack mortality."
A heart attack, or myocardial infarction, is blockage of an artery that prevents oxygen from reaching part of the heart. As a result, that part dies because the heart has no capacity to regenerate.
Could Become a Standard Treatment
If the use of insulin to counter post-heart attack inflammation proves useful, Dr. Dandona says it will join two other standard treatments used to deal with blocked arteries: insertion of an angioplasty balloon that is then expanded, forcing the artery to open up; and shooting a clot-dissolving drug into the artery.
"A regime of insulin to neutralize glucose - and, thus, inflammation - can reduce the tendency to clot," he says. "If you can do that, you can protect a large part of the heart from destruction."
Dr. Dandona says he and his colleagues look forward to insulin therapy becoming a standard treatment. "After that, we could see this treatment being applied to stroke victims. Insulin, once confined to the treatment of people with diabetes, now could treat inflammatory diseases. It's a treatment that could be applied to everybody."
Dr. Dandona has been studying insulin's ability to open up blood vessels and increase blood flow since 1993, the year he moved to Buffalo, N.Y., from the United Kingdom.
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