Intravenous magnesium for acute myocardial infarction

Li, Jing; Zhang, Qing; Zhang, Mingming; Egger, Matthias

doi:10.1002/14651858.cd002755.pub2

Cited by 44 publications

(33 citation statements)

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“…However, also a second large-scale randomized double-blind study with 6,213 patients and an earlier time point of Mg 2ϩ infusion (3.8 h compared with 8 h in ISIS-4) also failed to show a decrease on 30-day mortality rates (2). Indeed, a recent meta-analysis within the Cochrane collaboration concludes that there is no beneficial effect of Mg 2ϩ on mortality in AMI patients (OR 0.99, 95% CI 0.94 to 1.04) (312). However, it should be noted that the ISIS-4 study provides 72% of the power in this analysis and that the Mg 2ϩ doses used within the analyzed studies differ significantly.…”

Section: Myocardial Infarctionmentioning

confidence: 86%

Magnesium in Man: Implications for Health and Disease

Baaij

Hoenderop

Bindels

2015

Physiological Reviews

1,176

1,299

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Section: Myocardial Infarctionmentioning

confidence: 86%

Magnesium in Man: Implications for Health and Disease

Baaij

Hoenderop

Bindels

2015

Physiological Reviews

1,176

1,299

View full text Add to dashboard Cite

show abstract

“…We assessed rates of use only in patients thought to be ideal for treatment, defined (consistent with previously studies) as patients without documented contraindications (appendix 2). 15 We also assessed the use of magnesium sulfate (a treatment that is ineffective), 16,17 traditional Chinese medicine, other procedures, and tests. We included the seven main categories of traditional Chinese medicine used for coronary heart disease (appendix 2).…”

Section: Methodsmentioning

confidence: 99%

ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data

Li¹,

Li²,

Wang³

et al. 2015

The Lancet

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346

349

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Summary Background Despite the importance of ST-segment elevation myocardial infarction (STEMI) in China, no nationally representative studies have characterised the clinical profiles, management, and outcomes of this cardiac event during the past decade. We aimed to assess trends in characteristics, treatment, and outcomes for patients with STEMI in China between 2001 and 2011. Methods In a retrospective analysis of hospital records, we used a two-stage random sampling design to create a nationally representative sample of patients in China admitted to hospital for STEMI in 3 years (2001, 2006, and 2011). In the first stage, we used a simple random-sampling procedure stratified by economic–geographical region to generate a list of participating hospitals. In the second stage we obtained case data for rates of STEMI, treatments, and baseline characteristics from patients attending each sampled hospital with a systematic sampling approach. We weighted our findings to estimate nationally representative rates and assess changes from 2001 to 2011. This study is registered with ClinicalTrials.gov, number NCT01624883. Findings We sampled 175 hospitals (162 participated in the study) and 18 631 acute myocardial infarction admissions, of which 13 815 were STEMI admissions. 12 264 patients were included in analysis of treatments, procedures, and tests, and 11 986 were included in analysis of in-hospital outcomes. Between 2001 and 2011, estimated national rates of hospital admission for STEMI per 100 000 people increased (from 3·5 in 2001, to 7·9 in 2006, to 15·4 in 2011; ptrend<0·0001) and the prevalence of risk factors—including smoking, hypertension, diabetes, and dyslipidaemia—increased. We noted significant increases in use of aspirin within 24 h (79·7% [95% CI 77·9–81·5] in 2001 vs 91·2% [90·5–91·8] in 2011, ptrend<0·0001) and clopidogrel (1·5% [95% CI 1·0–2·1] in 2001 vs 82·1% [81·1–83·0] in 2011, ptrend<0·0001) in patients without documented contraindications. Despite an increase in the use of primary percutaneous coronary intervention (10·6% [95% CI 8·6–12·6] in 2001 vs 28·1% [26·6–29·7] in 2011, ptrend<0·0001), the proportion of patients who did not receive reperfusion did not significantly change (45·3% [95% CI 42·1–48·5] in 2001 vs 44·8% [43·1–46·5] in 2011, ptrend=0·69). The median length of hospital stay decreased from 12 days (IQR 7–18) in 2001 to 10 days (6–14) in 2011 (ptrend<0·0001). Adjusted in-hospital mortality did not significantly change between 2001 and 2011 (odds ratio 0·82, 95% CI 0·62–1·10, ptrend=0·07). Interpretation During the past decade in China, hospital admissions for STEMI have risen; in these patients, comorbidities and the intensity of testing and treatment have increased. Quality of care has improved for some treatments, but important gaps persist and inhospital mortality has not decreased. National efforts are needed to improve the care and outcomes for patients with STEMI in China.

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“…[12,13] Magnesium treatment may reduce the incidence of ventricular fi brillation, ventricular tachycardia, severe arrhythmia needing treatment or Lown 2-5, but it may increase the incidence of profound hypotension, bradycardia, and fl ushing. [14] Magnesium probably functions as an inorganic calcium channel blocker and there are several plausible mechanisms for a benefi cial effect in acute myocardial infarction (Woods 1991 (Ferrari 1986) (namely, the restoration of blood fl ow to an organ or tissue) and preserving intracellular Adenosine Triphosphate (ATP) and creatine phosphate reserves (Borchgrevink 1989), and inhibits platelet function, perhaps indirectly by release of prostacyclin (Watson 1986). Thus, magnesium-infusion started early after the onset of myocardial ischemia might limit infarct size, prevent serious arrhythmias, and reduce mortality.…”

Section: Discussionmentioning

confidence: 99%