INTRAVENOUS-INFUSION OF MAGNESIUM-SULFATE DOES NOT AFFECT IN-HOSPITALMORTALITY OF PATIENTS WITH SUSPECTED MYOCARDIAL-INFARCTION

Mortality data of a double blind randomized placebo controlled compara tive study of magnesium infusion vs placebo which comprised 117 patien ts with suspected acute myocardial infarction admitted within first 12 hours (median 4.9 hours) from pain onset are presented. Clinical char acteristics of patients included In this study were worse than those o f population of LIMIT-2 end ISIS-4 trials (frequency of clinical signs of heart failure - 46%, diabetes - 22.8%, previous myocardial infarct ion -35.1%, hypertension - 69.3%). Use of thrombolytic therapy was low (27.2%). intravenous magnesium (10.4 mmol bolus with subsequent 72.9 mmol infusion for median 23.9 hours) was given to 59 patients, placebo - to 58. Magnesium ion concentration (monitored in 15 patients) rose from 0.8+/-0.11 to 1.2+/-0.08 mmol/l (p=0.001) after bolus and remaine d on this level (1.3+/-0.25) until end of infusion in the treatment gr oup (n=9) and did not change in placebo group (0.8+/-0.09, 0.85+/-0.09 and 0.81+/-0.06 mmol/l, respectively, n=6). According to intention-to -treat analysis there were significantly less deaths in magnesium grou p infusion (0 versus 7, p=0.02) but this difference disappeared during subsequent two days. Overall there was no difference between groups i n mortality during hospitalization (20.3% in magnesium group versus 19 .0% in placebo group for 0-21 days,p=1.0). Thus, results of the presen t study do not support supposition that magnesium may have advantage o ver placebo in high risk patients with suspected acute myocardial infa rction.