Acute myocardial infarction without thrombolytic therapy: beneficial effects of magnesium sulfate.
Only one third of hospitalized patients with acute myocardial infarction (AMI) receive thrombolytic therapy despite its proven benefits on outcomes. Elderly patients, have a greater risk of death during myocardial infarction; however, thrombolytic therapy appears to be less used in these patients, as compared to the general AMI-patients. In order to evaluate the impact of magnesium supplementation in AMI-patients without thrombolytic therapy, 194 patients participated in a prospective, randomized and placebo-controlled study: 96 patients received a 48-hour intravenous magnesium sulfate and 98 isotonic glucose as placebo. Magnesium infusion reduced the incidence of arrhythmias, congestive heart failure and in-hospital-mortality compared with placebo (27 vs. 40%, p = 0.04; 18 vs. 23%, p = 0.27; 4 vs. 17%, p < 0.01, respectively); in the subgroup of elderly patients (> 70 years), the benefit was also obvious (42 vs. 50%; 18 vs. 25%; 9 vs. 23%, p = 0.09, respectively). These data suggest that intravenous magnesium supplementation might be justified in order to reduce myocardial damage and mortality rate in subsets of high-risk patients such the elderly and/or patients not suitable for thrombolysis. Additional trials appear to be indicated to evaluate the potential benefit of magnesium in well defined specific subsets of AMT-patients.
Shechter
M
M
Heart Institute, Sheba Medical Center, Tel Hashomer, Israel.
Hod
H
H
Chouraqui
P
P
Kaplinsky
E
E
Rabinowitz
B
B
D000368:Aged; D004311:Double-Blind Method; D006801:Humans; D007262:Infusions, Intravenous; D008278:Magnesium Sulfate / Q000008:administration & dosage*; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000188:drug therapy / Q000209:etiology / Q000401:mortality; D015912:Thrombolytic Therapy
D008278:Magnesium Sulfate