Evaluation of the intravenous magnesium sulfate effect in clinical improvement of patients with acute ischemic stroke

Afshari, Daryoush; Moradian, Nasrin; Rezaei, Mansour

doi:10.1016/j.clineuro.2012.06.001

Cited by 31 publications

(22 citation statements)

References 27 publications

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“…Some clinical studies found MgSO 4 treatment with AIS to be safe, but it did not decrease death or disability [18,19]. While in other studies, MgSO 4 treatment significantly improved the 3-months functional outcomes [20,21]. Further studies are needed to confirm the beneficial effect of such treatment in stroke patients.…”

Section: Discussionmentioning

confidence: 96%

Admission Low Magnesium Level Is Associated with In-Hospital Mortality in Acute Ischemic Stroke Patients

You

Zhong²,

Du³

et al. 2017

Cerebrovasc Dis

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Background: Low magnesium levels are associated with an elevated risk of stroke. In this study, we investigated the association between magnesium levels on hospital admission and in-hospital mortality in acute ischemic stroke (AIS) patients. Methods: A total of 2,485 AIS patients, enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city, were included in this study. The patients were divided into 4 groups according to their level of admission magnesium: Q1 (<0.82 mmol/L), Q2 (0.82-0.89 mmol/L), Q3 (0.89-0.98 mmol/L), and Q4 (≥0.98 mmol/L). Cox proportional hazard model was used to estimate the effect of magnesium on all-cause in-hospital mortality in AIS patients. Results: During hospitalization, 92 patients (3.7%) died from all causes. The lowest serum magnesium level (Q1) was associated with a 2.66-fold increase in the risk of in-hospital mortality in comparison to Q4 (hazard ratio [HR] 2.66; 95% CI 1.55-4.56; p-trend < 0.001). After adjusting for age, sex, time from onset to hospital admission, baseline National Institutes of Health Stroke Scale score, and other potential covariates, HR for Q1 was 2.03 (95% CI 1.11-3.70; p-trend = 0.014). Sensitivity and subgroup analyses further confirmed a significant association between lower magnesium levels and a high risk of in-hospital mortality. Conclusions: Decreased serum magnesium levels at admission were independently associated with in-hospital mortality in AIS patients.

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Section: Discussionmentioning

confidence: 96%

Admission Low Magnesium Level Is Associated with In-Hospital Mortality in Acute Ischemic Stroke Patients

You

Zhong²,

Du³

et al. 2017

Cerebrovasc Dis

View full text Add to dashboard Cite

show abstract

“…Speculations include that side effects might have outweighed the benefits and that administration time was not early enough. In another study performed in 2010 to 2011 with 107 patients (13), those who received MgSO 4 showed significant neurologic recoveries compared with the control participants. Although the intravenous infusion approach focuses on the provision of magnesium at the earliest possible time, our study provided a moderate amount of magnesium daily, suggesting that proper magnesium nutrition may be required for progressive neurologic improvement.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the neuroprotective effect from infusing magnesium sulfate (MgSO 4 ) has been documented in animal models (11). However, clinical trials intravenously administering relatively large doses of MgSO 4 to acute-phase stroke patients showed inconsistent results with respect to neurologic recoveries (12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Intake of potassium- and magnesium-enriched salt improves functional outcome after stroke: a randomized, multicenter, double-blind controlled trial

Pan

Lai

Yeh

et al. 2017

The American Journal of Clinical Nutrition

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Background: Stroke is one of the leading causes of mortality and neurologic deficits. Management measures to improve neurologic outcomes are in great need. Our previous intervention trial in elderly subjects successfully used salt as a carrier for potassium, demonstrating a 41% reduction in cardiovascular mortality by switching to potassium-enriched salt. Dietary magnesium has been associated with lowered diabetes and/or stroke risk in humans and with neuroprotection in animals. Objective: Because a large proportion of Taiwanese individuals are in marginal deficiency states for potassium and for magnesium and salt is a good carrier for minerals, it is justifiable to study whether further enriching salt with magnesium at an amount near the Dietary Reference Intake (DRI) amount may provide additional benefit for stroke recovery. Design: This was a double-blind, randomized controlled trial comprising 291 discharged stroke patients with modified Rankin scale (mRS) #4. There were 3 arms: 1) regular salt (Na salt) (n = 99), 2) potassium-enriched salt (K salt) (n = 97), and 3) potassium-and magnesium-enriched salt (K/Mg salt) (n = 95). The NIH Stroke Scale (NIHSS), Barthel Index (BI), and mRS were evaluated at discharge, at 3 mo, and at 6 mo. A good neurologic performance was defined by NIHSS = 0, BI = 100, and mRS #1. Results: After the 6-mo intervention, the proportion of patients with good neurologic performance increased in a greater magnitude in the K/Mg salt group than in the K salt group and the Na salt group, in that order. The K/Mg salt group had a significantly increased OR (2.25; 95% CI: 1.09, 4.67) of achieving good neurologic performance compared with the Na salt group. But the effect of K salt alone (OR: 1.58; 95% CI: 0.77, 3.22) was not significant. Conclusions: This study suggests that providing the DRI amount of magnesium and potassium together long term is beneficial for stroke patient recovery from neurologic deficits. This trial was registered at clinicaltrials.gov as NCT02910427.

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“…More promise has been found in the setting of ischemic stroke. A clinical trial performed by Afshari et al [36] suggested that treatment with magnesium within the first 12 h after onset of acute ischemic stroke is well tolerated and associated with improved neurological outcome.…”

Section: Magnesiummentioning

confidence: 98%

Update on anesthetic neuroprotection

Zwerus

Absalom

2015

Current Opinion in Anaesthesiology

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The evidence of benefit of current strategies remains sparse. Given the complex pathophysiology of cerebral ischemia and hypoxia, a multimodal approach to neuroprotective strategies seems sensible. The many variables and confounds associated with the clinical setting of patients, their comorbidities and concurrent medications, pose challenges to translate from experimental studies to clinical practice.

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Evaluation of the intravenous magnesium sulfate effect in clinical improvement of patients with acute ischemic stroke

Cited by 31 publications

References 27 publications

Admission Low Magnesium Level Is Associated with In-Hospital Mortality in Acute Ischemic Stroke Patients

Admission Low Magnesium Level Is Associated with In-Hospital Mortality in Acute Ischemic Stroke Patients

Intake of potassium- and magnesium-enriched salt improves functional outcome after stroke: a randomized, multicenter, double-blind controlled trial

Update on anesthetic neuroprotection

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