Document Detail


A prospective, nonrandomized, open-labeled pilot study investigating the use of magnesium in patients undergoing nonacute percutaneous coronary intervention with stent implantation.
MedLine Citation:
PMID:  14506544     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Magnesium has recently been shown to inhibit acute stent thrombosis in animal models. This study tested the feasibility of magnesium administration in patients undergoing nonacute percutaneous coronary intervention with stent implantation.
METHODS: Twenty-one patients undergoing nonemergent percutaneous coronary intervention were enrolled and received intravenous magnesium sulfate (2-g bolus over 20 minutes prepercutaneous coronary intervention, followed by 14 g over 12 hours infusion).
ENDPOINTS: safety outcomes--hypotension, bradycardia, bleeding complications and heart block within first 24 hours; angiographic outcomes--acute thrombotic occlusion and need for platelet glycoprotein IIb/IIIa inhibitor bailout; and clinical outcomes--death, myocardial infarction, recurrent ischemia, and need for urgent revascularization at 48 hours and 30 days.
RESULTS: No significant effects on heart rate or blood pressure, major bleeding complication, or new electrocardiographic changes were observed. Angiographic thrombus was visualized in two cases, and coronary artery dissection in one case poststent deployment. None of these cases required the use of glycoprotein inhibitors for bailout. Death, myocardial infarction, recurrent ischemia, and need for urgent revascularization were not observed. The serum magnesium level increased from 2.1 +/- 0.3 mg/dL at baseline to 3.5 +/- 0.8 mg/dL at the end of the infusion (P <.0001). Platelet activation was significantly inhibited at the end of the magnesium sulfate infusion.
CONCLUSION: Intravenous magnesium sulfate has been demonstrated as a feasible and safe agent in patients undergoing nonacute percutaneous coronary intervention with stent implantation. A randomized clinical trial comparing magnesium with glycoprotein inhibitors during percutaneous coronary intervention is warranted.
Authors:
Vladimir Rukshin; Raul Santos; Mitch Gheorghiu; Prediman K Shah; Saibal Kar; Sriram Padmanabhan; Babak Azarbal; Vivian T Tsang; Raj Makkar; Bruce Samuels; Norman Lepor; Ivor Geft; Steve Tabak; Mehran Khorsandhi; Neil Buchbinder; Neil Eigler; Bojan Cercek; Keta Hodgson; Sanjay Kaul
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular pharmacology and therapeutics     Volume:  8     ISSN:  1074-2484     ISO Abbreviation:  J. Cardiovasc. Pharmacol. Ther.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-24     Completed Date:  2003-12-02     Revised Date:  2014-07-28    
Medline Journal Info:
Nlm Unique ID:  9602617     Medline TA:  J Cardiovasc Pharmacol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  193-200     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary*
Coronary Angiography
Coronary Disease / blood,  radiography,  therapy
Coronary Thrombosis / etiology,  prevention & control*
Drug Administration Schedule
Electrocardiography
Humans
Infusions, Intravenous
Magnesium Sulfate / administration & dosage,  therapeutic use*
Male
Middle Aged
Pilot Projects
Platelet Aggregation / drug effects
Prospective Studies
Stents*
Treatment Outcome
Chemical
Reg. No./Substance:
7487-88-9/Magnesium Sulfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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