Does magnesium-supplemented cardioplegia reduce cardiac injury? A meta-analysis of randomized controlled trials

source extracted confidence: high 2026-04-09
#atrial-fibrillation #cardiac-output-low #cardioplegic-solutions #cardiopulmonary-bypass #cardiotonic-agents

Does magnesium-supplemented cardioplegia reduce cardiac injury? A meta-analysis of randomized controlled trials

Duan et al., 2015 | J Card Surg | Meta Analysis

Citation

Duan Lian, Zhang Chun-fang, ... Hu Guo-huang. Does magnesium-supplemented cardioplegia reduce cardiac injury? A meta-analysis of randomized controlled trials. J Card Surg. 2015-Apr;30(4):338-45. doi:10.1111/jocs.12518

Abstract

BACKGROUND: Magnesium is often used to supplement cardioplegic solutions during cardiopulmonary bypass due to its cardioprotective effect during ischemia and reperfusion. The aim of this meta-analysis was to evaluate the effects of magnesium-supplemented cardioplegia versus an inactive (placebo) control cardioplegia on reducing cardiac injury after cardiac arrest surgery, as found by randomized, controlled trials. METHODS: The Medline, Cochrane Library, and Chinese literature databases (CJFD, CBM, CSJD, Wanfang) were comprehensively searched for reports of randomized, controlled trials (RCTs) evaluating magnesium-supplemented cardioplegic solutions. The clinical parameters and outcomes of interest were the incidence of postoperative low cardiac output, auto-rebeating rate, ICU stay length, new onset postoperative atrial fibrillation, peak value of CK-MB (and/or cTnI), incidence of myocardial infarction, and in-hospital mortality. RESULTS: Ten trials, with a total of 1214 patients, were included. The frequency of low cardiac output, inotropic utilization, and myocardial infarction, as well as auto-rebeating rate, length of ICU stay and in-hospital mortality, were similar between the two groups. There was a marginal reduction in the incidence of new-onset postoperative atrial fibrillation in the magnesium-supplemented cardioplegia group. CONCLUSIONS: The advantage of magnesium-supplemented cardioplegia, compared with cardioplegia without magnesium, remains unconvincing based on the current evidence. The decision to add magnesium to the cardioplegic solution to a patient undergoing cardiac arrest surgery should be carefully considered.

Key Findings

Ten trials, with a total of 1214 patients, were included. The frequency of low cardiac output, inotropic utilization, and myocardial infarction, as well as auto-rebeating rate, length of ICU stay and in-hospital mortality, were similar between the two groups. There was a marginal reduction in the incidence of new-onset postoperative atrial fibrillation in the magnesium-supplemented cardioplegia group.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 1214
Age Range See abstract
Condition See abstract

MeSH Terms

  • Atrial Fibrillation
  • Cardiac Output, Low
  • Cardioplegic Solutions
  • Cardiopulmonary Bypass
  • Cardiotonic Agents
  • Databases, Bibliographic
  • Hospital Mortality
  • Humans
  • Incidence
  • Length of Stay
  • Magnesium
  • Myocardial Infarction
  • Postoperative Complications
  • Randomized Controlled Trials as Topic

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review
  • Vertical: magnesium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09