The Effect of Early Treatment with Intravenous Magnesium Sulfate on the Incidence of Cardiac Comorbidities in Hospitalized Stroke Patients.
Administration, Intravenous
Aged
Aged, 80 and over
Comorbidity
Drug Administration Schedule
Female
Heart Diseases
/ diagnosis
Hospitalization
Humans
Incidence
Los Angeles
/ epidemiology
Magnesium Sulfate
/ administration & dosage
Male
Middle Aged
Risk Factors
Stroke
/ diagnosis
Time Factors
Treatment Outcome
Journal
Cardiovascular therapeutics
ISSN: 1755-5922
Titre abrégé: Cardiovasc Ther
Pays: England
ID NLM: 101319630
Informations de publication
Date de publication:
2020
2020
Historique:
received:
19
03
2020
accepted:
07
07
2020
entrez:
19
10
2020
pubmed:
20
10
2020
medline:
12
11
2020
Statut:
epublish
Résumé
Cardiac adverse events are common among patients presenting with acute stroke and contribute to overall morbidity and mortality. Prophylactic measures for the reduction of cardiac adverse events in hospitalized stroke patients have not been well understood. We sought to investigate the effect of early initiation of high-dose intravenous magnesium sulfate on cardiac adverse events in stroke patients. This is a secondary analysis of the prehospital Field Administration of Stroke Therapy-Magnesium (FAST-MAG) randomized phase-3 clinical trial, conducted from 2005-2013. Consecutive patients with suspected acute stroke and a serum magnesium level within 72 hours of enrollment were selected. Twenty grams of magnesium sulfate or placebo was administered in the ambulance starting with a 15-minute loading dose intravenous infusion followed by a 24-hour maintenance infusion in the hospital. Among 1126 patients included in the analysis of this study, 809 (71.8%) patients had ischemic stroke, 277 (24.6%) had hemorrhagic stroke, and 39 (3.5%) with stroke mimics. The mean age was 69.5 (SD13.4) and 42% were female. 565 (50.2%) received magnesium treatment, and 561 (49.8%) received placebo. 254 (22.6%) patients achieved the target, and 872 (77.4%) did not achieve the target, regardless of their treatment group. Among 1126 patients, 159 (14.1%) had at least one CAE. Treatment with magnesium was not associated with fewer cardiac adverse events. A multivariate binary logistic regression for predictors of CAEs showed a positive association of older age and frequency of CAEs ( Treatment of acute stroke patients with magnesium did not result in a reduction in the number or severity of cardiac serious adverse events.
Sections du résumé
BACKGROUND
BACKGROUND
Cardiac adverse events are common among patients presenting with acute stroke and contribute to overall morbidity and mortality. Prophylactic measures for the reduction of cardiac adverse events in hospitalized stroke patients have not been well understood. We sought to investigate the effect of early initiation of high-dose intravenous magnesium sulfate on cardiac adverse events in stroke patients.
METHODS
METHODS
This is a secondary analysis of the prehospital Field Administration of Stroke Therapy-Magnesium (FAST-MAG) randomized phase-3 clinical trial, conducted from 2005-2013. Consecutive patients with suspected acute stroke and a serum magnesium level within 72 hours of enrollment were selected. Twenty grams of magnesium sulfate or placebo was administered in the ambulance starting with a 15-minute loading dose intravenous infusion followed by a 24-hour maintenance infusion in the hospital.
RESULTS
RESULTS
Among 1126 patients included in the analysis of this study, 809 (71.8%) patients had ischemic stroke, 277 (24.6%) had hemorrhagic stroke, and 39 (3.5%) with stroke mimics. The mean age was 69.5 (SD13.4) and 42% were female. 565 (50.2%) received magnesium treatment, and 561 (49.8%) received placebo. 254 (22.6%) patients achieved the target, and 872 (77.4%) did not achieve the target, regardless of their treatment group. Among 1126 patients, 159 (14.1%) had at least one CAE. Treatment with magnesium was not associated with fewer cardiac adverse events. A multivariate binary logistic regression for predictors of CAEs showed a positive association of older age and frequency of CAEs (
CONCLUSION
CONCLUSIONS
Treatment of acute stroke patients with magnesium did not result in a reduction in the number or severity of cardiac serious adverse events.
Identifiants
pubmed: 33072188
doi: 10.1155/2020/1494506
pmc: PMC7533752
doi:
Substances chimiques
Magnesium Sulfate
7487-88-9
Types de publication
Clinical Trial, Phase III
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
1494506Subventions
Organisme : NINDS NIH HHS
ID : U01 NS044364
Pays : United States
Informations de copyright
Copyright © 2020 Kameron Bechler et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interest.
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