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Use of Magnesium Sulphate in Patients
with Cardiac Infarction Without
Escobar, Hugo; Arias, Yanet;
Colunga, Justo; González, Angel.
Provincial Clinical Surgical Hospital
"Manuel Ascunce Domenech."
Introduction: Magnesium Sulphate provokes coronary vasodilatation, decreases arrhythmias, protects myocardium of necrosis induced by catecholamines and improves its energetic metabolism.
Objective: Evaluate benefits of the use of Magnesium Sulphate in patients with cardiac infarction non candidates to thrombolytic therapy.
Method: Analytical, cross-sectional and prospective study in 60 patients with diagnosis of acute myocardial infarction and contraindications to thrombolytic treatment, without cardiogenic shock, conduction disorders, renal failure and less than 12 hours after initiating pain, who were admitted in "Manuel Ascunce Domenech" Hospital of Camagüey, from January to December 2000. They were randomly divided into 2 groups: I (n=30) received 10% Magnesium Sulphate, 8 intravenous mmol in 5 min., followed by 64 mmol in infusion for 24 hours and II (n=30) with placebo. Electrocardiogram was performed at 12 hours and clinical follow-up.
Results: Masculine sex represented 58% and the 70% was among 45 and 74 years. Infarctions of anterior localization in 68; 47% was given Magnesium Sulphate before 6 hours after initiating pain and 57% the "door - needle" time was lower than 3 hours (p=0.03). No complications occurred. Facial flushing (6.6%) and arterial hypotension (10%) were adverse effects. Prevalence of cardiac failure decreases (Killip III - IV) (27% vs 33%; p=0.02) and mortality (13% vs 33%; p=0.03) in the magnesium group respect placebo.
Discussion: Limited study for the reduced numbers of patients. Magnesium Sulphate was well-tolerate and there was benefit with its administration decreasing mortality and prevalence of cardiac failure.
Conclusions: Magnesium Sulphate is a cheap, accessible and easy administration drug that lowers mortality in patients with cardiac infarction non candidates to thrombolytic therapy.
2nd Virtual Congress of Cardiology
Dr. Florencio Garófalo
Dr. Raúl Bretal
Dr. Armando Pacher
Technical Committee - CETIFAC
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