Results of randomized clinical trials of magnesium - Can a consensus be reached?

Coronary Artery Disease

Volumn 7, Issue 5, 1996, Pages 341-347

  Teo, Koon K ^a,b   McAlister, Finlay A ^a   Montague, Terrence J ^a  

^a UNIVERSITY OF ALBERTA   (Canada)

^b UNIVERSITY OF ALBERTA   (Canada)

Author keywords

acute myocardial infarction; clinical trials; magnesium

Indexed keywords

ANTITHROMBOCYTIC AGENT; CAPTOPRIL; MAGNESIUM;

ACUTE HEART INFARCTION; BLOOD CLOT LYSIS; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DRUG DESIGN; DRUG EFFICACY; DRUG MECHANISM; HUMAN; HUMAN CELL; HUMAN TISSUE; META ANALYSIS; PRIORITY JOURNAL; REVIEW; TREATMENT OUTCOME;

EID: 0029787514     PISSN: 09546928     EISSN: None     Source Type: Journal    
DOI: 10.1097/00019501-199605000-00002     Document Type: Review

References (42)

1. Yusuf S, Collins R, Peto R: Why do we need large, simple randomized trials? Stat Med 1984, 3:409-420. This article discusses the rationale for conducting large simple randomized trials in order to obtain reliable results when evaluating interventions that may have moderate but medically worthwhile effects.
2. Karppanen H: Epidemiological studies on the relationship between magnesium intake and cardiovascular diseases. Artery 1981, 9:190-199.
3. Leary WP, Reyes AJ, Lockett CJ, Arbuckle DD, van der Byl K: Magnesium and deaths ascribed to ischemic heart disease in South Africa. A preliminary report. S Afr Med J 1983, 64:775-776.
4. Arsenian MA: Magnesium and cardiovascular disease. Prog Cardiovasc Dis 1993, 35:271-310.
5. Chipperfield B, Chipperfield JR: Relation of myocardial metal concentration to water hardness and death rates from ischaemic heart disease. Lancet 1973, ii:709-712.
6. Luoma H, Aromaa A, Helminen S, Murtomaa H, Kiviluoto L, Punsar S, et al.: Risk of myocardial infarction in Finnish men in relation to fluoride, magnesium, and calcium concentration in drinking water. Acta Med Scand 1983, 213:171-176.
7. Flink EB, Brick JE, Shane SR: Alterations of long-chain free fatty acid and magnesium concentrations in acute myocardial infarction. Arch Intern Med 1981, 141:441-443.
8. Chang C, Varghese PJ, Downey J, Bloom S: Magnesium deficiency and myocardial infarct size in the dog. J Am Coll Cardiol 1985, 5:280-289.
9. Woods KL: Possible pharmacological actions of magnesium in acute myocardial infarction. Br J Clin Pharmacol 1991, 32:2-10. This article provides a comprehensive review of possible mechanisms of action of magnesium.
10. Yusuf S, Teo K, Woods K: Intravenous magnesium in acute myocardial infarction. An effective, safe, simple, and inexpensive intervention. Circulation 1993, 87:2043-2046.
11. Teo KK, Yusuf S, Collins R, Held PH, Teo R: Effect of intravenous magnesium in suspected acute myocardial infarction: overview of randomized trials. BMJ 1991, 303:1499-1503. This article proposes the hypothesis that was tested in ISIS-4 and LIMIT-2 trials [13,14].
12. Teo KK, Yusuf S: Role of magnesium in reducing mortality in acute myocardial infarction. A review of the evidence. Drugs 1993, 46:347-359.
13. Woods KL, Fletcher S, Roffe C, Haider Y: Intravenous magnesium sulphate in suspected acute myocardial infarction: results of the second Leicester Intravenous Magnesium Intervention Trial (LIMIT-2). Lancet 1992, 339:1553-1558. This article reports on the LIMIT-2 results.
14. ISIS-4 Collaborative Group: ISIS-4: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58 050 patients with suspected acute myocardial infarction. Lancet 1995, 345:669-682. This article reports on the ISIS-4 results.
15. Ceremuzynski L, Jurgiel R, Kulakowski P, Gebalska J: Threatening arrhythmias in acute myocardial infarction are prevented by intravenous magnesium sulphate. Am Heart J 1989, 118:1333-1334.
16. Abraham AS, Rosenmann D, Kramer M, Balkin J, Zion MM, Farbstein H, et al.: Magnesium in the prevention of lethal arrhythmias in acute myocardial infarction. Arch Intern Med 1987, 147:753-755.
17. Feldstedt M, Boesgaard S, Bouchelouche P, Svenningsen A, Brooks L, Lech Y, et al.: Magnesium substitution in acute ischaemic heart syndromes. Eur Heart J 1991, 12:1215-1218.
18. Morton BC, Nair RC, Smith FM, McKibbon TG, Poznanski WJ: Magnesium therapy in acute myocardial infarction - a double blind study. Magnesium 1984, 3:346-352.
19. Morton BC, Smith FM, McKibbon TG, Nair RC, Poznanski WJ. Magnesium therapy in acute myocardial infarction. Magnesium Bull 1981, 1:192-194.
20. Morton BC, Smith FM, Nair RC, McKibbon TG, Poznanski WJ. The clinical effects of magnesium sulfate treatment in acute myocardial infarction. Magnesium Bull 1984, 4:133-136.
21. Rasmussen HS, Norregard P, Lindeneg O, McNair P, Backer V, Balslev S: Intravenous magnesium in acute myocardial infarction. Lancet 1986, i:234-236.
22. Rasmussen HS, Gronbaek M, Cintin C, Balslov S, Norregard P, McNair P: One year death rate in 270 patients with suspected acute myocardial infarction, initially treated with intravenous magnesium or placebo. Clin Cardiol 1988, 11:377-381.
23. Shechter M, Hod H: Magnesium therapy in aged patients with acute myocardial infarction. Magnesium Bull 1991, 13:7-9.
24. Shechter M, Hod H, Kaplinsky E, Rabinowitz B. Magnesium administration in patients with acute myocardial infarction who are not candidates for thrombolytic therapy [abstract]. Eur Heart J 1991, 12:401.
25. Singh RB, Sircar AR, Rastogi SS, Garg V: Magnesium and potassium administration in acute myocardial infarction. Magnesium Trace Elements 1990, 9:198-204.
26. Smith LF, Heagerty AM, Bing RF, Barnett DB: Intravenous infusion of magnesium sulphate after acute myocardial infarction: effects on arrhythmias and mortality. Int J Cardiol 1986, 12:175-180.
27. Shechter M, Hod H, Marks N, Behar S, Kaplinsky E, Rabinowitz B: Beneficial effect of magnesium sulfate in acute myocardial infarction. Am J Cardiol 1990, 66:271-274.
28. Thogersen AM, Johnson O, Wester PO: Effects of intravenous magnesium sulphate in suspected acute myocardial infarction on acute arrhythmias and long-term outcome. Int J Cardiol 1995, 49:143-151.
29. Thogersen AM, Johnson O, Wester PO: Effects of magnesium infusion on thrombolytic and non-thrombolytic treated patients with acute myocardial infarction. Int J Cardiol 1993, 39:13-22.
30. Shechter M, Hod H, Chouraqui P, Kaplinsky E, Rabinowitz B: Magnesium therapy in acute myocardial infarction when patients are not candidates for thrombolytic therapy. Am J Cardiol 1995, 75:321-323.
31. Woods KL, Fletcher S: Long-term outcome after intravenous magnesium sulphate in suspected acute myocardial infarction: the second Leicester Intravenous Magnesium Intervention Trial (LIMIT-2). Lancet 1994, 343:816-819.
32. Egger M, Davey Smith G: Misleading meta-analysis: lessons from 'an effective, safe, simple' intervention that wasn't [editorial]. BMJ 1995, 310:752-754. This editorial discusses and provides insights into the interpretation of meta-analyses.
33. Gotzsche PC: Reference bias in reports of drug trials. BMJ 1987, 295:654-656.
34. Dickersin K, Min Y-I, Meinert CL: Factors influencing publication of research results. JAMA 1992, 267:374-378.
35. Yusuf S, Flather M: Magnesium in acute myocardial infarction: ISIS 4 provides no grounds for its routine use [editorial]. BMJ 1995, 310:751-752. This editorial discusses meta-analysis in the context of the ISIS-4 results.
36. Woods K: Mega-trials and management of acute myocardial infarction. Lancet 1995, 346:611-614. This article discusses the reasons why large trials may not answer the questions posed by clinicians.
37. Casscells W: Magnesium and myocardial infarction. Lancet 1994, 343:807-809.
38. Galloe A, Graudal N: Magnesium and myocardial infarction [letter]. Lancet 1994, 343:1286-1287.
39. du Toit EF, Opie LH: Modulation of severity of reperfusion stunning in the isolated rat heart by agents altering calcium flux at onset of reperfusion. Circ Res 1992, 70:960-967.
40. Antman EM: Randomized trials of magnesium in acute myocardial infarction: big numbers do not tell the whole story. Am J Cardiol 1995, 75:391-393.
41. Seelig MS, Elin RJ: Reexamination of magnesium infusions in myocardial infarction. Am J Cardiol 1995, 76:172-173.
42. The Clinical Quality Improvement Network (CQIN) Investigators: Mortality risk and patterns of practice in 4606 acute care patients with congestive heart failure. The relative importance of age, sex and medical therapy. Arch Intern Med (in press).