Interventional CardiologyA randomized study of intravenous magnesium in acute myocardial infarction treated with direct coronary angioplasty☆
Section snippets
Study population
Patients of any age were eligible when all the following inclusion criteria were fulfilled: (1) chest pain of >30 minutes’ duration associated with ≥0.1 mV ST-segment elevation in ≥2 contiguous electrocardiographic leads, (2) admission to the coronary care unit within 6 hours of symptom onset, (3) good acoustic window, and (4) no planned inclusion in other trials. Exclusion criteria were cardiogenic shock or severe hypotension with systolic blood pressure <90 mm Hg, sinus bradycardia <50
Randomization, treatment, and 30-day follow-up
Out of 183 consecutive screened patients, 150 (82%) were randomized. Reasons for nonrandomization of the remaining 33 are shown in Figure 1.Characteristics of the randomized patients are reported in Table I.Demographic and clinical characteristics, time from symptom onset to randomization, baseline echocardiography, and coronary angiography and procedural data of the two randomized groups did not show significant differences. The baseline mean
Discussion
Our study included a small sample of patients but its features were well suited to assess the hypothesis of a protective effect of magnesium against reperfusion injury. The infarct-related vessel was found completely occluded or with a markedly reduced anterograde flow (TIMI grade 0-1 flow) in 79% of the patients. The collateral flow to the infarct area was absent or poor (Rentrop grade 0-1) in 89% of the subjects. Coronary angioplasty was effective in 99% of the treated patients in reopening
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2011, AnesthesiologyCitation Excerpt :All patients received standard treatment. Magnesium treatment had no beneficial effects on the primary (30-day mortality) or the secondary outcome measures (incidence of heart failure).184 Several reasons for the lack of effect of magnesium administration were discussed.
Myocardial reperfusion injury
2007, New England Journal of MedicineReperfusion injury in humans: A review of clinical trials on reperfusion injury inhibitory strategies
2007, Cardiovascular ResearchPharmacologic Prevention of Myocardial Ischemia-Reperfusion Injury in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
2021, Journal of Cardiovascular PharmacologyThe effect of magnesium on reperfusion arrhythmias in stemi patients, treated with ppci. A systematic review with a meta-analysis and trial sequential analysis
2021, Frontiers in Cardiovascular Medicine
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Reprint requests: Giovanni M. Santoro, MD, Cardiology I, Careggi Hospital, Viale Morgagni 85, 50134 Florence, Italy. E-mail: [email protected]