Background. Cardiac adverse events are common among patients presenting with acute stroke and contribute to overall morbidity and mortality. Prophylactic measures for the reduction of cardiac adverse events in hospitalized stroke patients have not been well understood. We sought to investigate the effect of early initiation of high-dose intravenous magnesium sulfate on cardiac adverse events in stroke patients. Methods. This is a secondary analysis of the prehospital Field Administration of Stroke Therapy-Magnesium (FAST-MAG) randomized phase-3 clinical trial, conducted from 2005-2013. Consecutive patients with suspected acute stroke and a serum magnesium level within 72 hours of enrollment were selected. Twenty grams of magnesium sulfate or placebo was administered in the ambulance starting with a 15-minute loading dose intravenous infusion followed by a 24-hour maintenance infusion in the hospital. Results. Among 1126 patients included in the analysis of this study, 809 (71.8%) patients had ischemic stroke, 277 (24.6%) had hemorrhagic stroke, and 39 (3.5%) with stroke mimics. The mean age was 69.5 (SD13.4) and 42% were female. 565 (50.2%) received magnesium treatment, and 561 (49.8%) received placebo. 254 (22.6%) patients achieved the target, and 872 (77.4%) did not achieve the target, regardless of their treatment group. Among 1126 patients, 159 (14.1%) had at least one CAE. Treatment with magnesium was not associated with fewer cardiac adverse events. A multivariate binary logistic regression for predictors of CAEs showed a positive association of older age and frequency of CAEs (, 95% CI 1.03-1.06, ). Measures of early and 90-day outcomes did not differ significantly between the magnesium and placebo groups among patients who had CAEs. Conclusion. Treatment of acute stroke patients with magnesium did not result in a reduction in the number or severity of cardiac serious adverse events.

中文翻译：

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早期静脉注射硫酸镁对住院卒中患者心脏并发症发生率的影响

背景。心脏不良事件在急性卒中患者中很常见，并导致总体发病率和死亡率。减少住院卒中患者心脏不良事件的预防措施尚未得到充分了解。我们试图研究早期开始大剂量静脉注射硫酸镁对卒中患者心脏不良事件的影响。方法. 这是对 2005 年至 2013 年进行的院前脑卒中治疗现场管理 - 镁 (FAST-MAG) 随机 3 期临床试验的二次分析。选择入组后 72 小时内疑似急性中风和血清镁水平的连续患者。在救护车上给予 20 克硫酸镁或安慰剂，从 15 分钟的负荷剂量静脉输注开始，然后在医院进行 24 小时的维持输注。结果. 在纳入本研究分析的 1126 名患者中，809 名 (71.8%) 患者患有缺血性中风，277 名 (24.6%) 患有出血性中风，39 名 (3.5%) 患有类似中风。平均年龄为 69.5 (SD13.4)，42% 为女性。565 (50.2%) 人接受镁治疗，561 (49.8%) 人接受安慰剂。254 名 (22.6%) 患者达到目标，872 名 (77.4%) 未达到目标，无论其治疗组如何。在 1126 名患者中，159 名（14.1%）至少有 1 次 CAE。镁治疗与较少的心脏不良事件无关。CAEs 预测因子的多元二元逻辑回归显示年龄较大和 CAEs 频率呈正相关。, 95% CI 1.03-1.06,）。在患有 CAE 的患者中，镁组和安慰剂组的早期和 90 天结局指标没有显着差异。结论。用镁治疗急性卒中患者并未减少心脏严重不良事件的数量或严重程度。