10th International Magnesium Symposium Schedule of Events

23
A prospective non-randomized, open-labeled pilot study investigating the use
of magnesium in patients undergoing non-acute percutaneous coronary
intervention with stent implantation
Vladimir Rukshin, M.D., Raul Santos, M.D., Mitch Gheorghiu, M.D., Prediman K.
Shah, M.D., Saibal Kar, M.D., Sriram Padmanabhan, M.D., Babak Azarbal, M.D.,
Vivian T. Tsang, B.S., Raj Makkar, M.D., Bruce Samuels, M.D., Norman Lepor, M.D.,
Ivor Geft, M.D., Steve Tabak, M.D., Mehran Khorsandhi, M.D., Neil Buchbinder,
M.D., Neil Eigler, M.D., Bojan Cercek, M.D., Keta Hodgson, R.N., and Sanjay Kaul,
M.D.
From the Vascular Physiology and Thrombosis Research Laboratory of the
Atherosclerosis Research Center, the Burns and Allen Research Institute, the
Division of Cardiology and the Department of Medicine, Cedars-Sinai Medical Center
and UCLA School of Medicine, Los Angeles, California, USA. kaul@cshs.org
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 non-acute percutaneous coronary intervention
(PCI) with stent implantation.
METHODS - Twenty-one patients undergoing non-emergent PCI were enrolled and
received intravenous MgSO4 (2g bolus over 20 minutes pre-PCI followed by 14g
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 GP IIb/IIIa inhibitor (GPI) bailout;
and clinical outcomes - death, myocardial infarction (MI), 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 ECG changes were observed. Angiographic thrombus was
visualized in 2 cases, and coronary artery dissection in 1 case post-stent
deployment. None of these cases required the use of GPI for bailout. Death, MI,
recurrent ischemia and need for urgent revascularization were not observed. Serum
magnesium level increased from 2.1+0.3 at baseline to 3.5+0.8 mg/dL at the end of
infusion (P