Protective effects of intravenous magnesium sulfate in stroke patients receiving amiodarone: A randomized controlled trial

Objectives: Anti-arrhythmic agents, like amiodarone, interfere at different stages of the ischemic stroke. However, amiodarone was accompanied with immunological pulmonary complications and adverse neurological effects. We hypothesize that magnesium sulfate in combination with amiodarone holds promise for stroke treatment. Methods: Thirty-six patients with confirmed diagnosis of ischemic stroke and atrial fibrillation who received bolus amiodarone were randomly assigned to magnesium sulfate every 24 hours or similar volume of normal saline (as placebo) for 5 days. NIHSS (NIH Stroke Score), GCS (Glasgow Coma Scale), RASS (Richmond Agitation Sedation Scale), SOFA (Sequential organ failure assessment), APACHE II (Acute Physiology and Chronic Health Evaluation II), Candida scores were used to evaluate the severity of symptoms. Routing biochemistry were also measured at days 1 and 5. Results: Treatment with MgSO4 results in a significant reduction in serum levels of NGAL, Hb, T.Bill, IL-6, IL-8, SNSE, S100B, EGF, PAF, CRP and IgG, while having no statistical impact on the concentrations of FBS, WBC, ALT, BUN, Scr, K, PLT, AST, NA, lactate, TGF, PAI and IgA. Also, MgSO4 treatment significantly improved the RASS, Candida, SOFA, NIHSS and APACHE scores. Moreover, reduction of IL-6, IL-8, SNSE, EGF and APACHE score and increase in RASS score were significantly higher in MgSO4 group compared with placebo. Discussion: Intravenous administration of MgSO4 in amiodarone-treated stroke patients improved the inflammatory, immunological and neurological indicators and reduced disability in ICU-admitted AIS patients, suggesting that this treatment scheme may prevent amiodarone-induced complications in these patients.

کلیدواژه ها:

Ischemic stroke ، Amiodarone ، Magnesium sulfate ، Ischemia ، Severity ، Neuroprotection