title: Beneficial antithrombotic effects of the association of pharmacological oral magnesium therapy with aspirin in coronary heart disease patients.
abstract: The use of magnesium in the treatment of acute myocardial infarction remains controversial despite preliminary experimental evidence that magnesium plays a beneficial role as a regulator of thrombosis. The aim of our study was to determine whether oral magnesium treatment inhibits platelet-dependent thrombosis (PDT) in stable patients with coronary artery disease (CAD). In a randomized prospective, double-blind, cross-over and placebo controlled study, 42 patients with stable CAD (37 men, 5 women, mean age 68 +/- 9 years) on aspirin received either magnesium oxide tablets (800-1,200 mg/day) or placebo for 3 months (Phase 1) followed by a 4-week washout period, and the cross-over treatment for 3 months (Phase 2). PDT, platelet aggregation, platelet P-selectin flow-cytometry, monocyte tissue factor procoagulant activity (TF-PCA) and adhesion molecules density were assessed before and after each phase. PDT was evaluated by an ex-vivo perfusion model using the Badimon chamber. Median PDT was significantly reduced by 35 percent in patients who received magnesium versus placebo (D change from baseline: -24 vs. 26 microm2/mm; p = 0.02, respectively). There was no significant effect of magnesium treatment on platelet aggregation, P-selectin expression, monocyte TF-PCA or adhesion molecules. Oral magnesium treatment inhibits PDT in patients with stable CAD. This effect appears to be independent of platelet aggregation or P-selectin expression, and is evident despite aspirin therapy. These findings suggest a potential mechanism whereby magnesium may beneficially alter outcomes in patients with CAD.
authors.affiliation: Cedars-Sinai Burns and Allen Research Institute, Department of Medicine, Cedars-Sinai Medical Center and the UCLA School of Medicine Los Angeles, California, USA. shectes@netvision.net.il
authors.forename: M
authors.initials: M
authors.lastname: Shechter
authors.forename: C N
authors.initials: CN
authors.lastname: Merz
authors.forename: M
authors.initials: M
authors.lastname: Paul-Labrador
authors.forename: S R
authors.initials: SR
authors.lastname: Meisel
authors.forename: R K
authors.initials: RK
authors.lastname: Rude
authors.forename: M D
authors.initials: MD
authors.lastname: Molloy
authors.forename: J H
authors.initials: JH
authors.lastname: Dwyer
authors.forename: P K
authors.initials: PK
authors.lastname: Shah
authors.forename: S
authors.initials: S
authors.lastname: Kaul
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000008:administration & dosage* / Q000627:therapeutic use*; D002448:Cell Adhesion; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015243:Cholesterol, VLDL / Q000097:blood; D003327:Coronary Disease / Q000188:drug therapy*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004573:Electrolytes / Q000097:blood; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005434:Flow Cytometry; D006801:Humans; D008055:Lipids / Q000097:blood; D008274:Magnesium / Q000008:administration & dosage* / Q000627:therapeutic use*; D008277:Magnesium Oxide / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism; D019007:P-Selectin / Q000097:blood; D010919:Placebos; D010974:Platelet Aggregation / Q000187:drug effects; D011446:Prospective Studies; D013925:Thromboplastin / Q000378:metabolism; D013927:Thrombosis / Q000188:drug therapy
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015243:Cholesterol, VLDL; D004573:Electrolytes; D005343:Fibrinolytic Agents; D008055:Lipids; D019007:P-Selectin; D010919:Placebos; D008277:Magnesium Oxide; D013925:Thromboplastin; D008274:Magnesium; D001241:Aspirin