Shechter M, Hod H, Chouraqui P, Kaplinsky E, Rabinowitz B
Heart Institute, Sheba Medical Center, Tel Hashomer, Israel.
Herz. 1997 Jun;22 Suppl 1:73-6. doi: 10.1007/BF03042658.
Only one third of hospitalized patients with acute myocardial infarction (AMI) receive thrombolytic therapy despite its proven benefits on outcomes. Elderly patients, have a greater risk of death during myocardial infarction; however, thrombolytic therapy appears to be less used in these patients, as compared to the general AMI-patients. In order to evaluate the impact of magnesium supplementation in AMI-patients without thrombolytic therapy, 194 patients participated in a prospective, randomized and placebo-controlled study: 96 patients received a 48-hour intravenous magnesium sulfate and 98 isotonic glucose as placebo. Magnesium infusion reduced the incidence of arrhythmias, congestive heart failure and in-hospital-mortality compared with placebo (27 vs. 40%, p = 0.04; 18 vs. 23%, p = 0.27; 4 vs. 17%, p < 0.01, respectively); in the subgroup of elderly patients (> 70 years), the benefit was also obvious (42 vs. 50%; 18 vs. 25%; 9 vs. 23%, p = 0.09, respectively). These data suggest that intravenous magnesium supplementation might be justified in order to reduce myocardial damage and mortality rate in subsets of high-risk patients such the elderly and/or patients not suitable for thrombolysis. Additional trials appear to be indicated to evaluate the potential benefit of magnesium in well defined specific subsets of AMT-patients.
尽管溶栓治疗已被证明对急性心肌梗死（AMI）患者的预后有益，但住院的AMI患者中只有三分之一接受了溶栓治疗。老年患者在心肌梗死期间死亡风险更高；然而，与一般AMI患者相比，这些患者似乎较少使用溶栓治疗。为了评估在未接受溶栓治疗的AMI患者中补充镁的影响，194名患者参与了一项前瞻性、随机和安慰剂对照研究：96名患者接受了48小时静脉注射硫酸镁，98名患者接受等渗葡萄糖作为安慰剂。与安慰剂相比，输注镁降低了心律失常、充血性心力衰竭和住院死亡率的发生率（分别为27%对40%，p = 0.04；18%对23%，p = 0.27；4%对17%，p < 0.01）；在老年患者（>70岁）亚组中，益处也很明显（分别为42%对50%；18%对25%；9%对23%，p = 0.09）。这些数据表明，为了降低高危患者亚组（如老年人和/或不适合溶栓的患者）的心肌损伤和死亡率，静脉补充镁可能是合理的。似乎需要进行更多试验来评估镁在明确界定的特定AMI患者亚组中的潜在益处。
