Magnesium Supplementation and Tachyarrhythmias: A Nonrandomized Clinical Trial
Goulden R, Abrahamowicz M, Strumpf E, Tamblyn R
JAMA internal medicine · 4 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Ensayo clínico controlado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2025-12-08 · JAMA Intern Med · vol. 186 · número 2 · pág. 183
- Editorial
- American Medical Association
- Citado
- 6 citas · más que el 92% de estudios similares · 3.0× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 32 trabajos
- Acceso
- Acceso abierto (copia en repositorio)
- Áreas de investigación
- Magnesium in Health and Disease · Potassium and Related Disorders · Parathyroid Disorders and Treatments
- Palabras clave
- Magnesium, Magnesium deficiency (plants), Clinical trial, Randomized controlled trial
- MeSH
- humans, tachycardia, tachycardia, supraventricular, magnesium, dietary supplements, aged, middle aged, intensive care units, female, male
4 autores
- Robert Goulden🇨🇦McGill University Health Centre; McGill University
- Michał Abrahamowicz🇨🇦McGill University
- Erin Strumpf🇨🇦McGill University
- Robyn M Tamblyn🇨🇦McGill University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Importance
Magnesium supplementation is regularly given to acutely ill patients with serum levels below the standard reference range, primarily for the prevention of tachyarrhythmias, such as atrial fibrillation. The evidence for this practice and the specific treatment thresholds used is limited. Conventional observational studies of this question are at risk of confounding by indication and other biases.
Objective
To determine whether giving magnesium supplementation to patients with hypomagnesemia, as defined by a given institution's usual treatment cutoff, reduces adverse clinical outcome using a quasi-experimental study design that plausibly allows for causal inference.
Design, setting, and participants
This nonrandomized clinical trial of intensive care unit (ICU) patients undergoing serum magnesium testing was conducted in 93 ICUs across the US and Europe between 2003 and 2022. A fuzzy regression discontinuity design was used, in which individuals just either side of the eligibility cutoff for magnesium supplementation were compared with regard to the study outcomes. This comparison was performed across a range of treatment cutoffs in current use, ranging from 1.6 mg/dL to 2.0 mg/dL. Data were analyzed from August to October 2025.
Exposures
Magnesium supplementation.
Main outcomes and measures
The primary outcome was ventricular or supraventricular tachyarrhythmia in the 24 hours after magnesium testing. Secondary outcomes were the occurrence of hypotension or death.
Results
A total of 478 901 twenty-four-hour treatment windows from 171 727 ICU admissions were included in the study. A total of 72 767 admitted patients (42.4%) were female, 98 960 (57.6%) were male, and the mean (SD) age of the cohort was 63 (16) years. There was no evidence of an effect of magnesium supplementation on the occurrence of tachyarrhythmia, with a risk difference of 0.1% (95% CI, -4.2 to 6.9). This was true across all the cutoff levels evaluated. There was similarly no association with the occurrence of hypotension (risk difference, 1.2%; 95% CI, -0.9 to 17.7) or death (risk difference, 1.4%; 95% CI, -0.6 to 5.3).
Conclusions and relevance
In this nonrandomized clinical trial, routine supplementation of magnesium with currently used doses and treatment thresholds was not associated with beneficial effects for individuals with serum magnesium values close to those cutoffs.
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