A prospective, nonrandomized, open-labeled pilot study investigating the use of magnesium in patients undergoing nonacute percutaneous coronary intervention with stent implantation.
A prospective, nonrandomized, open-labeled pilot study investigating the use of magnesium in patients undergoing nonacute percutaneous coronary intervention with stent implantation.
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DOI：
10.1177/107424840300800304
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发表时间：
2003-09-01
影响因子：
2.6
通讯作者：
Kaul, Sanjay
中科院分区：
文献类型：
--
作者：
Rukshin, Vladimir;Santos, Raul;Kaul, Sanjay
背景：最近在动物模型中发现镁可抑制急性支架内血栓形成。本研究测试了镁在接受非急性经皮冠状动脉介入治疗和支架植入术的患者中的可行性。研究方法：21例接受非紧急经皮冠状动脉介入治疗的患者入组并接受静脉注射硫酸镁（经皮冠状动脉介入治疗前20分钟内推注2 g，随后12小时内输注14 g）。终点：安全性结局-最初24小时内的低血压、心动过缓、出血并发症和心脏传导阻滞;血管造影结局-急性血栓性闭塞和需要血小板糖蛋白IIb/IIIa抑制剂急救;以及临床结局-死亡、心肌梗死、复发性缺血和在48小时和30天需要紧急血运重建。结果：未观察到对心率或血压、主要出血并发症或新的心电图变化的显著影响。在支架展开后，2例患者的血管造影显示血栓，1例患者显示冠状动脉夹层。这些病例均不需要使用糖蛋白抑制剂进行急救。未观察到死亡、心肌梗死、复发性缺血和需要紧急血运重建。血清镁水平从基线时的2.1 ± 0.3 mg/dL增加到输注结束时的3.5 ± 0.8 mg/dL（P
Background: Magnesium has recently been shown to inhibit acute stent thrombosis in animal models. This study tested the feasibility of magnesium administration in patients undergoing nonacute percutaneous coronary intervention with stent implantation. Methods: Twenty-one patients undergoing nonemergent percutaneous coronary intervention were enrolled and received intravenous magnesium sulfate (2-g bolus over 20 minutes prepercutaneous coronary intervention, followed by 14 g over 12 hours infusion). Endpoints: safety outcomes-hypotension, bradycardia, bleeding complications and heart block within first 24 hours; angiographic outcomes-acute thrombotic occlusion and need for platelet glycoprotein IIb/IIIa inhibitor bailout; and clinical outcomes-death, myocardial infarction, recurrent ischemia, and need for urgent revascularization at 48 hours and 30 days. Results: No significant effects on heart rate or blood pressure, major bleeding complication, or new electrocardiographic changes were observed. Angiographic thrombus was visualized in two cases, and coronary artery dissection in one case poststent deployment. None of these cases required the use of glycoprotein inhibitors for bailout. Death, myocardial infarction, recurrent ischemia, and need for urgent revascularization were not observed. The serum magnesium level increased from 2.1+-0.3 mg/dL at baseline to 3.5+-0.8 mg/dL at the end of the infusion (P