Original article: cardiovascularThe efficacy of supplemental magnesium in reducing atrial fibrillation after coronary artery bypass grafting
Section snippets
Material and methods
After local institutional review board approval, patients undergoing elective isolated coronary artery bypass grafting (CABG) were approached for consent. The study was conducted over a 5-year period in a midwestern university medical center, which includes a 562-bed and a 606-bed hospital. After consent, 202 patients were randomly assigned to receive either placebo or prophylactic supplemental magnesium. The pharmacy staff assigned patients to study and control groups using a randomization
Results
A total of 202 patients were enrolled in the study. One hundred-five patients were in the Mg group and 97 were assigned as controls. There were no significant differences in preoperative and operative variables except the mean cross-clamp time was about 5 minutes longer in the experimental group (E), 61.11 ± 21.1, versus control group (C) 55 ± 21.89 minutes (p = 0.04). Age, sex, preoperative albumin, preoperative and postoperative renal function, preoperative and postoperative use of
Comment
Magnesium is an important cation in cardiovascular physiology. Supplemental Mg creates a β-adrenergic blocking effect on the myocardial cell by affecting the G proteins; those play a role in the signaling path of the β-adrenergic stimuli in myocytes 14, 15. Mg is also an important cofactor in maintaining the intracellular electrolyte balance and membrane potentials by altering the activity of Na-K-ATP channels and it also acts like a natural Ca antagonist 1, 3, 14, 15.
Low Mg levels are a
Acknowledgements
This work was funded, in part, by Southern Illinois University School of Medicine, Central Research Committee Grant: Efficacy of Magnesium in Reducing Cardiac Dysrhythmias.
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Prophylactic magnesium does not prevent atrial fibrillation after cardiac surgery: A meta-analysis
2013, Annals of Thoracic SurgeryCitation Excerpt :The results of the literature search, inclusions, and exclusions are summarized in Figure 1. The study and patient characteristics of the 21 included trials [14, 17–36] are summarized in Table 1. The earliest trial was published in 1988 [25] and the most recent was published in 2009 [34].
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2012, International Journal of CardiologyCitation Excerpt :Hypomagnesemia increases the risk of supraventricular arrhythmias [12]. However, the net effect of magnesium loading on postoperative AF incidence is equivocal: Hazelrigg et al. [17] found no effect, whereas the meta-analyses of Shiga et al. [18] and Miller et al. [15] found a significant reduction, and more recently, Cook et al. found no effect of magnesium loading in the largest randomized, placebo-controlled trial for the prevention of AF after CABG or cardiac valvular surgery [19]. However, none of the previous magnesium trials addressed the relation between the rate of myocardial extraction of magnesium and the pathophysiology of post operative AF, or the effect of magnesium loading on the rate of myocardial extraction of magnesium.
Systemic magnesium to reduce postoperative arrhythmias after coronary artery bypass graft surgery: A meta-analysis of randomized controlled trials
2012, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :The characteristics of included studies are listed in Table 1. The evaluated trials included data from 3,696 subjects and were published between 1988 and 2009.8,9,27-44 The median number of patients in the included studies receiving systemic magnesium was 77.