EFFECTS OF ORAL SUCROSE AND OF ESTIMATED INFARCT SIZE ON PLASMA-FREE FATTY-ACIDS, PLASMA-GLUCOSE AND SERUM-INSULIN IN THE EARLY STAGES OF ACUTE MYOCARDIAL-INFARCTION

Abstract. Twenty‐two patients with early myocardial infarction were studied to test the effect of oral sucrose as an antilypolytic agent. Without sucrose, plasma free fatty acids rose to a peak (mean 1.48 mM/l 8 h after onset of symptoms) and then fell spontaneously by 32% of the peak level in 2 h. Sucrose had no effect on the peak fatty acid level and did not accelerate the initial rate of fall in the first 2 h. Where the peak free fatty acid was less than 1.5 mM/l, however, it fell to a lower level in patients given sucrose (P < 0.05). A subsequent rebound of free fatty acid values, as seen in starved patients, was delayed for about 6 h in sucrose‐fed patients. The responses of free fatty acid, glucose and insulin varied according to the size of the infarct as estimated by the plasma creatine kinase method. Patients with larger infarcts (>65 creatine kinase gram equivalents) had higher insulin and blood sugar levels on and after admission, and had higher plasma free fatty acid peaks than patients with smaller infarcts (≤65 creatine kinase gram equivalents). When patients with larger infarcts were given oral sucrose, the rise in blood glucose was higher and more sustained than in patients with small infarcts and there was no insulin response. The insulin response to sucrose was normal in those with smaller infarcts. Thus oral sucrose was an effective antilipolytic agent only in patients with smaller infarcts. Copyright © 1979, Wiley Blackwell. All rights reserved