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Effect of magnesium on restenosis after percutaneous transluminal coronary angioplasty: a clinical and angiographic evaluation in a randomized patient population
A pilot study
A. ROTH*, Y. ESHCHAR*, G. KEREN*, S. KERBEL*, A. HARSAT†, Y. VILLA‡, S. LANIADO* and H. I. MILLER*
+ Author Affiliations

*Departments of Cardiology, Tel-Aviv Sourasky Medical Center Israel
†Clinical Chemistry, Tel-Aviv Sourasky Medical Center Israel
‡Department of Mathematics and Statistics, Sackler School of Medicine, Tel-Aviv University Israel
Correspondence: Arie Roth, MD, Department of Cardiology, Tel-Aviv Medical Center, 6 Weizman St, Tel-Aviv 64239, Israel.
Abstract

Restenosis is a major clinical problem following successful percutaneous transluminal coronary angioplasty. Since magnesium has vasodilator and antithrombotic effects, this study was designed to evaluate its potential to decrease the rate of restenosis.

In an open-labelled, randomized controlled study, 148 patients underwent successful coronary angioplasty. Ninety-eight patients were treated with 46—52 mmoll 18–20 h intravenous magnesium sulphate (groups Ml and M2), and 49 of them continued with oral supplements of magnesium hydroxide 600 mg. day−1 (group M2).The other 50 patients served as controls (group C). Coronary angiography was performed before, immediately after and at 6 months follow-up or earlier if clinically indicated. Clinical, laboratory, ergometric and radionuclide evaluations were also carried out.

One hundred and thirty-nine patients (94%) with 163 dilated segments completed the study. Intravenous magnesium was well tolerated The cross-sectional area at the site of angioplasty increased by 3.55 ± 201 mm2 in groups Ml and M2 compared with an increase of 2.90 ± 163 mm2 in the control group, (P=003). A trend towards a lower rate of restenosis (>50% reduction in luminal diameter) was noticed in the magnesium groups (28/110, 25%) compared with the control group (20/53, 38%) P=0.10. Oral administration of magnesium was well tolerated, did not have an additive effect on restenosis, but an improved clinical course was noted.

It is concluded that intravenous administration of magnesium in patients undergoing coronary angioplasty is feasible and safe and that the beneficial trend of magnesium to prevent acute recoil and late (within 6 months) restenosis is encouraging and should promote further investigation in a larger patient population.

Magnesium ion: a possible physiological regulator of aldosterone production.
Atarashi K, Matsuoka H, Takagi M, Sugimoto T.
Source
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Japan.
Abstract
We examined the direct effect of magnesium ion on aldosterone production by adrenal cells using collagenase-dispersed zona-glomerulosa cells in rats. The effects of magnesium on aldosterone production stimulated by angiotensin II or ACTH were also investigated. Both magnesium sulphate (MgSO4) and magnesium chloride (MgCl2) (0 to 2 mM) decreased aldosterone production in a dose-dependent manner. In comparison with magnesium-free medium, 2 mM MgSO4 inhibited aldosterone production by 73% and MgCl2 by 65%. In addition, MgSO4 showed an inhibitory effect on aldosterone production stimulated by angiotensin II (10pM to 10nM), whereas it had no significant effect on aldosterone production due to ACTH stimulation (10pM to 10nM). These data suggest that magnesium has an inhibitory action on aldosterone production in vitro and may be a physiological regulator of aldosterone production.