The Magnesium in Coronaries Study (MAGIC)
Objectives:
To determine whether early intravenous magnesium
treatment of patients with suspected acute myocardial infarction reduces
mortality.
Background:
Mortality rate from ST-elevation myocardial infarction
(STEMI) remains high in elderly patients and in patients who are not eligible
for reperfusion therapy. Intravenous magnesium is a promising adjunctive
treatment that may reduce reperfusion injury. Several earlier trials
demonstrated a mortality rate reduction with magnesium treatment, but one large
trial found no benefit. If magnesium proves beneficial, its use will provide a
simple, cost-effective means to improve survival in this large patient
population.
Subjects:
Magnesium in Coronaries (MAGIC) is a large, simple
trial designed to maximize the potential treatment effect of magnesium. A total
of 6,213 high-risk patients with ST-elevation myocardial infarction were
randomly assigned to early treatment with intravenous magnesium sulfate or
matching placebo. The primary end point was death at 30 days. Information on
the need for treatment of shock and sustained ventricular arrhythmias were
collected to investigate the mechanisms by which magnesium might exert a
beneficial effect.
Conclusions:
Early administration of magnesium in high-risk
patients with STEMI had no effect on 30-day mortality. There was no indication
for the routine administration of magnesium in patients with STEMI (LANCET
2002; 360: 1189-1196).
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