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End of the debate for magnesium treatment after heart attack for high-risk patients?

N.B. Please note that if you are outside North America the embargo date for all Lancet Press material is 0001 hours UK time Friday 18 Oct 2002

Lancet

An international trial published in this week's issue of THE LANCET should end the debate about the use of intravenous magnesium for high-risk patients after heart attack--the investigators report no benefit for magnesium treatment compared with placebo.

The benefits of supplementary administration of intravenous magnesium in patients with a specific heart-attack profile known as ST-elevation myocardial infarction (STEMI) are controversial. Despite promising results from work in animals and the ready availability of this simple, inexpensive treatment, conflicting results have been reported in clinical trials.

Elliott Antman from Brigham and Womens Hospital, Boston, USA, and colleagues report the results of a randomised, double-blind trial comparing magnesium supplementation with placebo in around 6200 patients with acute STEMI.

There was no difference in death after 30 days--the main outcome measure of the trial--between patients given magnesium or placebo (15.3% and 15.2%, respectively).

Elliott M Antman comments: "Early administration of magnesium in high-risk patients with STEMI has no effect on 30-day mortality. In view of the totality of the available evidence, in current coronary care practice there is no indication for the routine administration of intravenous magnesium in patients with STEMI."

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Contact: Dr Elliott M Antman, Cardiovascular Division, Department of Medicine, Brigham & Womens Hospital, 75 Francis Street, Boston MA 02115, USA;
T) 617-732-7143;
F) 617-975-0990;
E) eantman@rics.bwh.harvard.edu

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