Effect of magnesium sulphate in patients with unstable angina

Aim Administration of intravenous magnesium sulphate has been shown to be protective during acute myocardial ischaemia and it may therefore have beneficial effects in unstable angina. The purpose of this study was to assess the effects of a 24-h infusion of magnesium in patients with unstable angina...

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Published in:European heart journal 1997-08, Vol.18 (8), p.1269-1277
Main Authors: Redwood, S. R., Bashir, Y., Huang, J., Leatham, E. W., Kaski, J.-C., Camm, A. J.
Format: Article
Language:English
Subjects:
catecholamines
ischaemia
Magnesium
unstable angina
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container_end_page 1277
container_issue 8
container_start_page 1269
container_title European heart journal
container_volume 18
creator Redwood, S. R.
Bashir, Y.
Huang, J.
Leatham, E. W.
Kaski, J.-C.
Camm, A. J.
description Aim Administration of intravenous magnesium sulphate has been shown to be protective during acute myocardial ischaemia and it may therefore have beneficial effects in unstable angina. The purpose of this study was to assess the effects of a 24-h infusion of magnesium in patients with unstable angina. Methods and results Patients who presented with unstable angina with electrocardiographic changes were randomized to receive a 24-h intravenous infusion of magnesium or placebo within 12 h of admission. The primary endpoint was myocardial ischaemia, as assessed by 48 h Holter monitoring. Resting 12-lead ECGs, creatine kinase-MB release and urinary catecholamines were also assessed. Patients were followed for 1 month. Thirty-one patients received magnesium sulphate and 31 placebo. Baseline characteristics and extent of coronary disease were similar in both groups. On 48 h Holter monitoring, 14 patients (50%) had transient ST segment shifts in the magnesium group vs 12 patients (46%) in the placebo group. However, there were fewer ischaemic episodes in the magnesium group (51 vs 101, P
doi_str_mv 10.1093/oxfordjournals.eurheartj.a015438
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R. ; Bashir, Y. ; Huang, J. ; Leatham, E. W. ; Kaski, J.-C. ; Camm, A. J.</creatorcontrib><description>Aim Administration of intravenous magnesium sulphate has been shown to be protective during acute myocardial ischaemia and it may therefore have beneficial effects in unstable angina. The purpose of this study was to assess the effects of a 24-h infusion of magnesium in patients with unstable angina. Methods and results Patients who presented with unstable angina with electrocardiographic changes were randomized to receive a 24-h intravenous infusion of magnesium or placebo within 12 h of admission. The primary endpoint was myocardial ischaemia, as assessed by 48 h Holter monitoring. Resting 12-lead ECGs, creatine kinase-MB release and urinary catecholamines were also assessed. Patients were followed for 1 month. Thirty-one patients received magnesium sulphate and 31 placebo. Baseline characteristics and extent of coronary disease were similar in both groups. On 48 h Holter monitoring, 14 patients (50%) had transient ST segment shifts in the magnesium group vs 12 patients (46%) in the placebo group. However, there were fewer ischaemic episodes in the magnesium group (51 vs 101, P&lt;0·001) and there was a trend towards an increase in the total duration of ischaemia in the placebo group compared to the magnesium group in the second 24 h (2176 min vs 719 min respectively, P=0·08). Regression of T wave changes on the 24 h ECG occurred more frequently in patients who received magnesium compared to those treated with placebo (11 patients vs 0 patients respectively, P&lt;0·005). Creatine kinase-MB release was significantly less at 6 and 24 h in patients who received magnesium compared to those treated with placebo. Catecholamine excretion was lower in patients treated with magnesium than in those treated with placebo (adrenaline: 1·05±0·16 vs 1·61±0·32 ng . mmol−1 creatinine; noradrenaline: 9·99±1·82 vs 18·48±2·41 ng.mmol−1 creatinine respectively in the first 12 h sample, P&lt;0·05). Conclusion Intravenous magnesium reduces ischaemic ECG changes, creatine kinase-MB release and urinary catecholamine excretion in the acute phase of unstable angina. Thus, magnesium may be a beneficial additional therapy for these patients. Further studies are required to confirm these findings.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/oxfordjournals.eurheartj.a015438</identifier><language>eng</language><publisher>Oxford University Press</publisher><subject>catecholamines ; ischaemia ; Magnesium ; unstable angina</subject><ispartof>European heart journal, 1997-08, Vol.18 (8), p.1269-1277</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Redwood, S. R.</creatorcontrib><creatorcontrib>Bashir, Y.</creatorcontrib><creatorcontrib>Huang, J.</creatorcontrib><creatorcontrib>Leatham, E. W.</creatorcontrib><creatorcontrib>Kaski, J.-C.</creatorcontrib><creatorcontrib>Camm, A. J.</creatorcontrib><title>Effect of magnesium sulphate in patients with unstable angina</title><title>European heart journal</title><description>Aim Administration of intravenous magnesium sulphate has been shown to be protective during acute myocardial ischaemia and it may therefore have beneficial effects in unstable angina. The purpose of this study was to assess the effects of a 24-h infusion of magnesium in patients with unstable angina. Methods and results Patients who presented with unstable angina with electrocardiographic changes were randomized to receive a 24-h intravenous infusion of magnesium or placebo within 12 h of admission. The primary endpoint was myocardial ischaemia, as assessed by 48 h Holter monitoring. Resting 12-lead ECGs, creatine kinase-MB release and urinary catecholamines were also assessed. Patients were followed for 1 month. Thirty-one patients received magnesium sulphate and 31 placebo. Baseline characteristics and extent of coronary disease were similar in both groups. On 48 h Holter monitoring, 14 patients (50%) had transient ST segment shifts in the magnesium group vs 12 patients (46%) in the placebo group. However, there were fewer ischaemic episodes in the magnesium group (51 vs 101, P&lt;0·001) and there was a trend towards an increase in the total duration of ischaemia in the placebo group compared to the magnesium group in the second 24 h (2176 min vs 719 min respectively, P=0·08). Regression of T wave changes on the 24 h ECG occurred more frequently in patients who received magnesium compared to those treated with placebo (11 patients vs 0 patients respectively, P&lt;0·005). Creatine kinase-MB release was significantly less at 6 and 24 h in patients who received magnesium compared to those treated with placebo. Catecholamine excretion was lower in patients treated with magnesium than in those treated with placebo (adrenaline: 1·05±0·16 vs 1·61±0·32 ng . mmol−1 creatinine; noradrenaline: 9·99±1·82 vs 18·48±2·41 ng.mmol−1 creatinine respectively in the first 12 h sample, P&lt;0·05). Conclusion Intravenous magnesium reduces ischaemic ECG changes, creatine kinase-MB release and urinary catecholamine excretion in the acute phase of unstable angina. Thus, magnesium may be a beneficial additional therapy for these patients. Further studies are required to confirm these findings.</description><subject>catecholamines</subject><subject>ischaemia</subject><subject>Magnesium</subject><subject>unstable angina</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><recordid>eNqVzbtuwjAUgGGrAqmh9B08dklqE-wkQyfERUJCDB0Qi3Voj4nTxIl8EfD2dOAFmP7lk35CPjjLOKvyz_6qe_fb9NFZaH2G0dUILjQZMC7meflCEi5ms7SSczEiCeOVSKUsD69k4n3DGCsllwn5WmqNP4H2mnZwtuhN7KiP7VBDQGosHSAYtMHTiwk1jdYHOLVIwZ6NhSkZ6_87vj_6RtLV8nuxSY0PeFWDMx24mwL3p2SRF0JtDke1k0XBt3yt9vmz_g6zEU14</recordid><startdate>199708</startdate><enddate>199708</enddate><creator>Redwood, S. R.</creator><creator>Bashir, Y.</creator><creator>Huang, J.</creator><creator>Leatham, E. W.</creator><creator>Kaski, J.-C.</creator><creator>Camm, A. J.</creator><general>Oxford University Press</general><scope>BSCLL</scope></search><sort><creationdate>199708</creationdate><title>Effect of magnesium sulphate in patients with unstable angina</title><author>Redwood, S. R. ; Bashir, Y. ; Huang, J. ; Leatham, E. W. ; Kaski, J.-C. ; Camm, A. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-istex_primary_ark_67375_HXZ_N6771K1G_P3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>catecholamines</topic><topic>ischaemia</topic><topic>Magnesium</topic><topic>unstable angina</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Redwood, S. R.</creatorcontrib><creatorcontrib>Bashir, Y.</creatorcontrib><creatorcontrib>Huang, J.</creatorcontrib><creatorcontrib>Leatham, E. W.</creatorcontrib><creatorcontrib>Kaski, J.-C.</creatorcontrib><creatorcontrib>Camm, A. J.</creatorcontrib><collection>Istex</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Redwood, S. R.</au><au>Bashir, Y.</au><au>Huang, J.</au><au>Leatham, E. W.</au><au>Kaski, J.-C.</au><au>Camm, A. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of magnesium sulphate in patients with unstable angina</atitle><jtitle>European heart journal</jtitle><date>1997-08</date><risdate>1997</risdate><volume>18</volume><issue>8</issue><spage>1269</spage><epage>1277</epage><pages>1269-1277</pages><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Aim Administration of intravenous magnesium sulphate has been shown to be protective during acute myocardial ischaemia and it may therefore have beneficial effects in unstable angina. The purpose of this study was to assess the effects of a 24-h infusion of magnesium in patients with unstable angina. Methods and results Patients who presented with unstable angina with electrocardiographic changes were randomized to receive a 24-h intravenous infusion of magnesium or placebo within 12 h of admission. The primary endpoint was myocardial ischaemia, as assessed by 48 h Holter monitoring. Resting 12-lead ECGs, creatine kinase-MB release and urinary catecholamines were also assessed. Patients were followed for 1 month. Thirty-one patients received magnesium sulphate and 31 placebo. Baseline characteristics and extent of coronary disease were similar in both groups. On 48 h Holter monitoring, 14 patients (50%) had transient ST segment shifts in the magnesium group vs 12 patients (46%) in the placebo group. However, there were fewer ischaemic episodes in the magnesium group (51 vs 101, P&lt;0·001) and there was a trend towards an increase in the total duration of ischaemia in the placebo group compared to the magnesium group in the second 24 h (2176 min vs 719 min respectively, P=0·08). Regression of T wave changes on the 24 h ECG occurred more frequently in patients who received magnesium compared to those treated with placebo (11 patients vs 0 patients respectively, P&lt;0·005). Creatine kinase-MB release was significantly less at 6 and 24 h in patients who received magnesium compared to those treated with placebo. Catecholamine excretion was lower in patients treated with magnesium than in those treated with placebo (adrenaline: 1·05±0·16 vs 1·61±0·32 ng . mmol−1 creatinine; noradrenaline: 9·99±1·82 vs 18·48±2·41 ng.mmol−1 creatinine respectively in the first 12 h sample, P&lt;0·05). Conclusion Intravenous magnesium reduces ischaemic ECG changes, creatine kinase-MB release and urinary catecholamine excretion in the acute phase of unstable angina. Thus, magnesium may be a beneficial additional therapy for these patients. Further studies are required to confirm these findings.</abstract><pub>Oxford University Press</pub><doi>10.1093/oxfordjournals.eurheartj.a015438</doi></addata></record>
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source Oxford Journals Online
subjects catecholamines
ischaemia
Magnesium
unstable angina
title Effect of magnesium sulphate in patients with unstable angina
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