Cardioprotective effects of magnesium sulfate in patients undergoing primary coronary angioplasty for acute myocardial infarction.
BACKGROUND
Experimental evidence indicates that magnesium sulfate may have potential cardioprotective properties as an adjunct to coronary reperfusion. The present study was designed to examine the hypothesis that magnesium might have beneficial effects on left ventricular (LV) function and coronary microvascular function in patients with acute myocardial infarction (AMI).


RESULTS
The study population of 180 consecutive patients with a first AMI (anterior or inferior) underwent successful primary coronary intervention. Patients were randomized to treatment with either intravenous magnesium (magnesium group, n=89) or normal saline (control group, n=91). Pre-discharge left ventriculograms were used to assess LV ejection fraction (LVEF), regional wall motion (RWM) within the infarct-zone and LV end-diastolic volume index. The Doppler guidewire was used to assess coronary flow velocity reserve (CFVR) as an index of coronary microvascular function. Magnesium group subjects showed significantly better LV systolic function (LVEF 63+/-9% vs 55+/-13%, p<0.001; RWM: -1.01+/-1.29 SD/chord vs -1.65+/-1.11 SD/chord, p=0.004), significantly smaller LV end-diastolic volume index (63+/-17 ml/m(2) vs 76+/-20 ml/m(2), p<0.001), and significantly higher CFVR (2.95+/-0.76 vs 2.50+/-0.99, p=0.023) than controls.


CONCLUSIONS
Magnesium sulfate as an adjunct to primary coronary intervention shows favorable functional outcomes in patients with AMI.
Nakashima
Hiroshi
H
Department of Cardiology, Nagasaki Citizens Hospital, Japan. sk4h-nksm@asahi-net.or.jp
Katayama
Toshiro
T
Honda
Yukiharu
Y
Suzuki
Shin
S
Yano
Katsusuke
K
D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001794:Blood Pressure; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D003097:Collateral Circulation; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008297:Male; D008833:Microcirculation / Q000503:physiopathology; D009203:Myocardial Infarction / Q000628:therapy*; D012189:Retrospective Studies
D002316:Cardiotonic Agents; D008278:Magnesium Sulfate