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. 1993 Sep 4;307(6904):585–587. doi: 10.1136/bmj.307.6904.585

Influence of oral magnesium supplementation on cardiac events among survivors of an acute myocardial infarction.

A M Galløe 1, H S Rasmussen 1, L N Jørgensen 1, P Aurup 1, S Balsløv 1, C Cintin 1, N Graudal 1, P McNair 1
PMCID: PMC1678932  PMID: 8401013

Abstract

OBJECTIVE--To investigate the effect of long term oral magnesium treatment on incidence of cardiac events among survivors of an acute myocardial infarction. DESIGN--Double blind, placebo controlled parallel study in which patients were randomised to treatment or placebo. SETTING--Two coronary care units and corresponding outpatient clinics. SUBJECTS--468 survivors of an acute myocardial infarction (289 men and 178 women) aged 31-92. INTERVENTIONS--One tablet of 15 mmol magnesium hydroxide or placebo daily for one year. MAIN OUTCOME MEASURES--Incidences of reinfarction, sudden death, and coronary artery bypass grafting in one year. RESULTS--There was no significant difference between treatment and placebo groups in the incidence of each of the three cardiac events, but when the events were combined and drop outs were excluded from calculations there was a significantly higher incidence of events in the treatment group (56/167 v 33/153; relative risk 1.55 (95% confidence interval 1.07 to 2.25); p = 0.02). When the timing of events was incorporated by means of a Kaplan-Meier plot the treatment group showed a significantly higher incidence of events whether drop outs were included or excluded (p < 0.025). CONCLUSION--Long term oral treatment with 15 mmol magnesium daily doses not reduce the incidence of cardiac events in survivors of an acute myocardial infarction and, indeed, seems to increase the risk of developing a cardiac event. Consequently, this treatment cannot be recommended as secondary prophylaxis for such patients.

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Selected References

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  1. Abraham A. S., Eylath U., Weinstein M., Czaczkes E. Serum magnesium levels in patients with acute myocardial infarction. N Engl J Med. 1977 Apr 14;296(15):862–863. doi: 10.1056/NEJM197704142961509. [DOI] [PubMed] [Google Scholar]
  2. Altura B. M., Altura B. T., Carella A., Turlapaty P. D. Hypomagnesemia and vasoconstriction: possible relationship to etiology of sudden death ischemic heart disease and hypertensive vascular diseases. Artery. 1981;9(3):212–231. [PubMed] [Google Scholar]
  3. Altura B. M., Altura B. T. Magnesium ions and contraction of vascular smooth muscles: relationship to some vascular diseases. Fed Proc. 1981 Oct;40(12):2672–2679. [PubMed] [Google Scholar]
  4. Dyckner T., Wester P. O. Intracellular magnesium loss after diuretic administration. Drugs. 1984 Oct;28 (Suppl 1):161–166. doi: 10.2165/00003495-198400281-00016. [DOI] [PubMed] [Google Scholar]
  5. Flink E. B., Brick J. E., Shane S. R. Alterations of long-chain free fatty acid and magnesium concentrations in acute myocardial infarction. Arch Intern Med. 1981 Mar;141(4):441–443. [PubMed] [Google Scholar]
  6. Lim P., Jacob E. Magnesium deficiency in patients on long-term diuretic therapy for heart failure. Br Med J. 1972 Sep 9;3(5827):620–622. doi: 10.1136/bmj.3.5827.620. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Magnesium infusion in acute myocardial infarction. Lancet. 1986 Mar 8;1(8480):551–552. [PubMed] [Google Scholar]
  8. Morton B. C., Nair R. C., Smith F. M., McKibbon T. G., Poznanski W. J. Magnesium therapy in acute myocardial infarction--a double-blind study. Magnesium. 1984;3(4-6):346–352. [PubMed] [Google Scholar]
  9. Petersen B., Christiansen C., Transbøl I. Blood minerals in cardiac emergencies. Dan Med Bull. 1978 Apr;25(3):116–118. [PubMed] [Google Scholar]
  10. Rasmussen H. S., Aurup P., Hojberg S., Jensen E. K., McNair P. Magnesium and acute myocardial infarction. Transient hypomagnesemia not induced by renal magnesium loss in patients with acute myocardial infarction. Arch Intern Med. 1986 May;146(5):872–874. doi: 10.1001/archinte.146.5.872. [DOI] [PubMed] [Google Scholar]
  11. Rasmussen H. S., Grønbaek M., Cintin C., Balsløv S., Nørregård P., McNair P. One-year death rate in 270 patients with suspected acute myocardial infarction, initially treated with intravenous magnesium or placebo. Clin Cardiol. 1988 Jun;11(6):377–381. doi: 10.1002/clc.4960110604. [DOI] [PubMed] [Google Scholar]
  12. Rasmussen H. S., McNair P., Gøransson L., Balsløv S., Larsen O. G., Aurup P. Magnesium deficiency in patients with ischemic heart disease with and without acute myocardial infarction uncovered by an intravenous loading test. Arch Intern Med. 1988 Feb;148(2):329–332. [PubMed] [Google Scholar]
  13. Rasmussen H. S., McNair P., Norregard P., Backer V., Lindeneg O., Balslev S. Intravenous magnesium in acute myocardial infarction. Lancet. 1986 Feb 1;1(8475):234–236. doi: 10.1016/s0140-6736(86)90773-7. [DOI] [PubMed] [Google Scholar]
  14. Rector W. G., Jr, DeWood M. A., Williams R. V., Sullivan J. F. Serum magnesium and copper levels in myocardial infarction. Am J Med Sci. 1981 Jan-Feb;281(1):25–29. doi: 10.1097/00000441-198101000-00004. [DOI] [PubMed] [Google Scholar]
  15. Rudnicki M., Frølich A., Fischer-Rasmussen W. Magnesium supplement in pregnancy-induced hypertension: effects on maternal and neonatal magnesium and calcium homeostasis. Miner Electrolyte Metab. 1991;17(6):399–403. [PubMed] [Google Scholar]
  16. Ryzen E., Elkayam U., Rude R. K. Low blood mononuclear cell magnesium in intensive cardiac care unit patients. Am Heart J. 1986 Mar;111(3):475–480. doi: 10.1016/0002-8703(86)90051-7. [DOI] [PubMed] [Google Scholar]
  17. Teo K. K., Yusuf S., Collins R., Held P. H., Peto R. Effects of intravenous magnesium in suspected acute myocardial infarction: overview of randomised trials. BMJ. 1991 Dec 14;303(6816):1499–1503. doi: 10.1136/bmj.303.6816.1499. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Woods K. L., Fletcher S., Roffe C., Haider Y. Intravenous magnesium sulphate in suspected acute myocardial infarction: results of the second Leicester Intravenous Magnesium Intervention Trial (LIMIT-2) Lancet. 1992 Jun 27;339(8809):1553–1558. doi: 10.1016/0140-6736(92)91828-v. [DOI] [PubMed] [Google Scholar]

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