ST elevation myocardial infarction magnesium therapy
| Myocardial infarction | |
| ICD-10 | I21-I22 |
|---|---|
| ICD-9 | 410 |
| DiseasesDB | 8664 |
| MedlinePlus | 000195 |
| eMedicine | med/1567 emerg/327 ped/2520 |
| Cardiology Network |
 Discuss ST elevation myocardial infarction magnesium therapy further in the WikiDoc Cardiology Network |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
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Mechanism of Benefit
Between 1980 and 2002, a total of 68 684 patients were studied in a series of 15 randomized trials. On the basis of the totality of available evidence, in current coronary care practice, there is no indication for the routine administration of intravenous magnesium to patients with STEMI at any level of risk.
Magnesium can continue to be administered for repletion of documented electrolyte deficits and life-threatening ventricular arrhythmias such as torsade de pointes.[1][2]
Guidelines (DO NOT EDIT)
Class IIa
1. It is reasonable that documented magnesium deficits be corrected, especially in patients receiving diuretics before the onset of STEMI. (Level of Evidence: C)
2. It is reasonable that episodes of torsade de pointes type VT associated with a prolonged QT interval be treated with 1 to 2 grams of magnesium administered as an IV bolus over 5 minutes. (Level of Evidence: C)
Class III
1. In the absence of documented electrolyte deficits or torsade de pointes type VT, routine intravenous magnesium should not be administered to STEMI patients at any level of risk. (Level of Evidence: A)
References
- ↑ Woods KL, Abrams K (2002). "The importance of effect mechanism in the design and interpretation of clinical trials: the role of magnesium in acute myocardial infarction". Prog Cardiovasc Dis. 44 (4): 267–74. PMID 12007082.
- ↑ Antman EM, Anbe DT, Armstrong PW; et al. (2004). "ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction)". Circulation. 110 (5): 588–636. doi:10.1161/01.CIR.0000134791.68010.FA. PMID 15289388. Unknown parameter
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External links
- Risk Assessment Tool for Estimating Your 10-year Risk of Having a Heart Attack - based on information of the Framingham Heart Study, from the United States National Heart, Lung and Blood Institute
- Heart Attack - overview of resources from MedlinePlus.
- Heart Attack Warning Signals from the Heart and Stroke Foundation of Canada
- Regional PCI for STEMI Resource Center - Evidence based online resource center for the development of regional PCI networks for acute STEMI
- STEMI Systems - Articles, profiles, and reviews of the latest publications involved in STEMI care. Quarterly newsletter.
- American College of Cardiology (ACC) Door to Balloon (D2B) Initiative.
- American Heart Association's Heart Attack web site - Information and resources for preventing, recognizing and treating heart attack.