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2001, Número 4

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Arch Cardiol Mex 2001; 71 (4)


El magnesio en el tratamiento del infarto agudo del miocardio. Revisión y controversias

Juárez HU, Antman EM

Idioma: Español
Referencias bibliográficas: 48
Paginas: 335-344
Archivo PDF: 93.34 Kb.


RESUMEN

La utilización del magnesio en el tratamiento del infarto agudo del miocardio es motivo de controversia, pues su aplicación rutinaria no es una práctica establecida. Hay bases fisiológicas que atribuyen al magnesio propiedades de protección miocárdica sobre todo en relación con la terapia de reperfusión. En este trabajo se analizan los aspectos básicos del metabolismo del magnesio y sus efectos en el sistema cardiovascular, así como los efectos benéficos de este catión: en la prevención de arritmias, efectos antiplaquetarios, vasodilatación coronaria y prevención del daño por reperfusión, así mismo los riesgos de su aplicación en la cardiopatía isquémica. Ya que los resultados en los principales estudios han originado debate, se señalan las principales diferencias entre estos estudios y cuales son las posibles explicaciones al respecto y que dan como consecuencia diferencia en la interpretación de los hallazgos.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Goldman RS, Finkbeiner SM: Therapeutic use of magnesium sulfate in selected cases of cerebral ischemia and seizure. N Engl J Med 1988; 319: 1224-25.

  2. Szabo MD, Crosby G: Central Nervous Sistem effects of magnesium. Anesth Analg 1989; 69: 691-692.

  3. Okayama H, Aikawa T, Okayama M: Bronchodilating effect of intravenous magnesium sulfate in bronchial asthma. J Am Med Assoc 1987; 257: 1076-78.

  4. Freek WA: Acute Coronary Syndromes: Drug Treatments. Lancet 1999: 353(Suppl II) 20-23

  5. Iseri LT, French JH: Magnesium: Nature’s physiologic calcium blocker. Am Heart J 1984; 108 (1): 188-193.

  6. 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.

  7. ISIS-4 Collaborative Group: A Randomized factorial trial assessing early oral captopril,oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. Lancet. 1995; 345: 669-685.

  8. Rodríguez-Zavala JS: Bioquímica y Fisiología del Mg2+ en el corazón y en otros órganos. Arch Inst Cardiol Méx 1998; 68: 262-272.

  9. Guyton C, Hall E: Textbook of Medical Physiology. Integration of renal mechanisms for control of blood volume and extracelular fluid volume; and renal regulation of potasium, calcium and magnesium. 9a Edition, Philadelphia, Pennsylvania; W.B. Saunders Company 1996; 382.

  10. Zaloga GP: Interpretation of seric level of magnesium. Chest 1989; 95: 257-258.

  11. Braunwald E, Kloner RA: Myocardial Reperfusion: a double-edged sword? J Clin Invest. 1985; 76: 1713-1719.

  12. Bolli R: Oxygen-derived free radicals and postischemic myocardial disfunction (“Stunned myocardium”). J Am Coll Cordiol 1988; 12: 239-249.

  13. Steenbergen C, Murphy E, Levy L, London RE: Elevation in cytosolic concentration early in myocardial ischemia in perfused rat heart. Circ Res 1987; 60: 700-707.

  14. Woods KL: Possible pharmacological actions of magnesium in acute myocardial infarction. Br J Clin Pharmacol 1991; 32: 3-10.

  15. White RE, Hartzell HC: Effects of intracellular free magnesium on calcium current in isolated cardiac myocites. Science 1988; 239: 778-780

  16. Ferrari R, Curello AS, Cecconi C: Myocardial recovery during post-ischaemic reperfusion: Effects of nifedipine, calcium,and magnesium. J Mol Cell Cardiol 1986; 18: 487-498.

  17. Herase DJ, Stewart DA, Bradimbirdge MV: Cellular protection during myocardial ischemia. Circulation 1976; 54: 193-202.

  18. de Micheli A, Medrano GA, Testelli M, Sodi Pallares D: L’action de certaines substances chimiques sur l’électrogramme et la courbe de tensión artérielle chez le chien. Mal Cardiovasc 1963; 4(2): 607-649.

  19. de Micheli A, Medrano GA, Sodi Pallares D: Efectos de algunas soluciones electrolíticas sobre la evolución electrocardiográfica del infarto experimental agudo del miocardio. Arch Inst Cardiol Mex 1963; 33: 567-580.

  20. Medrano GA, de Micheli A, Sodi Pallares D: Les potentiels des structures spécifiques du coeur et leurs relations chronologiques avec l’électrocardiogramme périphérique chez le chien. Acta Cardiol 1962; 17: 731-760.

  21. DiCarlo LA, Morady F, De Buitleir M: Effects of magnesium sulfate on cardiac conduction and refractoriness in humans. J Am Coll Cardiol 1986; 7(6): 1356-1362.

  22. Roden DM: Magnesium treatment of ventricular arrhythmias. Am J Cardiol 1989; 63: 43G-46G.

  23. Vigorito C, Giordano A, Ferrano P: Haemodinamics effects of magnesium sulphate on the normal human heart. Am J Cardiol 1991; 67: 1435-1437.

  24. Kugiyama K, Yasue H, Okumura K: Suppression of exercise-induced angina by magnesium sulphate in patients with variant angina. J Am Coll Cardiol 1988; 12(5): 177-183.

  25. Kemp PA, Gardiner SM, March JE: Hindquarters vasodilator effect of MgSo4 in conscious rats: Possible involvement of nitric oxide . Br J Pharmacol 1992; 107: 403P.

  26. Smetana R, Brichta, Glogar D, Gottsauner-Wolf M, Weindlmayr-Goettl M, Meisinger V, Spona J: Stress and magnesium metabolism in coronary artery disease. Magnesium Bull 1991; 13: 125-127.

  27. Casscells W: Magnesium in myocardial infarction. Lancet 1994; 343: 807-809.

  28. Johnson CJ, Peterson PR, Smith EK: Myocardial tissue concentrations of magnesium and potassium in men dying suddenly from ischemic heart disease. Am J Clin Nutr 1979; 32: 967-970.

  29. Bolli R: Myocardial Stunning in man. Circulation 1992; 86: 1671-1691.

  30. Resnick LM: Cellular ions in hypertension, insulin resistence, obesity,and diabetes: A unifying theme. J Am Soc Nephrol 1992; 3: S78-S85.

  31. Adams JH, Mitchell JRA: The effect of agents which modify platelet behaviour and of magnesium ions on thrombus formation in vivo. Thromb Haemostas 1979; 42: 603-610

  32. Hwang DL, Yen CF, Nadler JL: Effect of extracellular magnesium on platelet activation and intracellular calcium mobilization. Am J Hypertens 1992; 5: 700-706.

  33. Nadler JL, Goodson S, Rude R: Evidence that prostacycline mediates the vascular action of magnesium in humans. Hypertension 1987; 9: 379-383.

  34. Paddle BM,Haugaard N: Role of magnesium in effects of epinephrine on heart concentration and metabolism. Am J Physiol 1971; 221: 1178-1184.

  35. Teo KK, Yusuf S, Collins R: Effects of intravenous magnesium in suspected acute myocardial infarction: An overview of the randomized trials. Br Med J 1991; 303: 1499-1503.

  36. Grupo Italiano per lo Studio della Streptochinasi nell’infarto miocardico (GISSI): Long-term effects of intravenous thrombolysis in acute myocardial infarction: final report of the GISSI study. Lancet 1987; 2: 871-874.

  37. Morton BC, Nair RC, Smith FM, McKibbon TG, Poznanzky WJ: Magnesium therapy in acute myocardial infarction: a double blind study. Magnesium 1984; 3: 346-352.

  38. Shechter M, Hod H, Chouraqui P, Kaplinsky E, Rabinowits B: Magnesium therapy in acute myocardial infarction when patients are not candidates for thrombolytic therapy. Am J Cardiol 1995; 75: 321-323.

  39. Woods KL: Mega-trials in management in acute myocardial infarction. Lancet 1995; 346611-614.

  40. DeWood MA, Spores J, Notske RN, Simpson JS, Eugster GS, Judge TP, Hinnen ML: Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. N Engl J Med 1980; 333: 897-902.

  41. National Research Council. Combining information: Statistical issues and opportunities for research. Washington National Academy Press; 1992.

  42. Antman EM, Lau J, Berkey C, McIntosh M, Chalmers TC, Mosteller F: Large versus small trials of magnesium for acute myocardial infarction: big numbers do not tell the whole story. Circulation 1994; 90(Suppl I): 325.

  43. Berkey CS, Hoaglin DC, Mosteller F, Colditz GA: A random-effects regression model for meta-analisis. Stat Med 1995; 14: 395-411.

  44. Antman EM: Magnesium in acute myocardial infarction: overview of available evidence. Am Heart J 1996; 132 (2) (Suppl-II): 487-495.

  45. Yusuf S, Teo KK, Woods KL: Intravenous magnesium in acute myocardial infarction. Circulation 1993; 87(6); 2043-2046.

  46. Borzak S, Ridker PM: Discordance between meta-analyses and large-scale randomized, controlled trials. Examples from the management of acute myocardial infarction. Ann Intern Med 1995; 123: 873-877.

  47. Ziegelstein R, Hilbe JM, French WJ, Antman EM, Chandra-Strobos N: Magnesium Use in the Treatment of Acute Myocardial Infarction in the United States (Observations from the Second National Registry of Myocardial Infarction ) Am J Cardiol 2001; 87: 7-10.

  48. MAGIC Study (Magnesium in Coronaries): A clinical Trial to reevaluate the efficacy of early administration of magnesium in acute myocardial infarction. Am Heart J 2000; 139: 10-24




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