Magnesium as an adjunct to nimodipine in subarachnoid hemorrhage: a meta-analysis
Background Subarachnoid hemorrhage (SAH) is a devastating neurological condition with high morbidity and mortality rates. Although nimodipine is widely used in the management of SAH, the potential benefits of magnesium as adjunct therapy remain unclear. This meta-analysis aimed to evaluate the effic...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Yeungnam University College of Medicine, Yeungnam University Institute Medical Science
2025-02-01
|
| Series: | Journal of Yeungnam Medical Science |
| Subjects: | |
| Online Access: | http://www.e-jyms.org/upload/pdf/jyms-2025-42-26.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849763470691532800 |
|---|---|
| author | Riva Satya Radiansyah Yuri Pamungkas Ilham Ikhtiar |
| author_facet | Riva Satya Radiansyah Yuri Pamungkas Ilham Ikhtiar |
| author_sort | Riva Satya Radiansyah |
| collection | DOAJ |
| description | Background Subarachnoid hemorrhage (SAH) is a devastating neurological condition with high morbidity and mortality rates. Although nimodipine is widely used in the management of SAH, the potential benefits of magnesium as adjunct therapy remain unclear. This meta-analysis aimed to evaluate the efficacy and safety of combining magnesium with nimodipine for the management of SAH. Methods A comprehensive literature search was conducted using PubMed, ScienceDirect, Google Scholar, and the Cochrane Library. Randomized controlled trials and prospective cohort studies comparing magnesium plus nimodipine versus nimodipine alone in patients with SAH were included. Key outcomes included cerebral vasospasm (CV), delayed cerebral ischemia (DCI), functional outcomes, mortality, and adverse events. Results Twelve studies involving 2,338 patients were included. The combination of magnesium and nimodipine significantly reduced the incidence of CV (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.29–0.95; p=0.03) and DCI (OR, 0.52; 95% CI, 0.31–0.87; p=0.01) compared to nimodipine alone. However, no significant differences were found in functional outcomes (modified Rankin Scale: OR, 0.97; p=0.75; Glasgow Outcome Scale: OR, 0.81; p=0.24), mortality (OR, 0.97; p=0.83), or secondary cerebral infarction (OR, 0.38; p=0.12). The incidence of adverse events was higher in the combination group; however, this difference was not statistically significant (OR, 3.14; p=0.33). Conclusion Adding magnesium to nimodipine therapy in patients with SAH may help reduce CV and DCI incidence but does not significantly improve functional outcomes or mortality. Further large-scale studies are needed to optimize the dosing regimens and confirm these findings. |
| format | Article |
| id | doaj-art-4dc25dbfe0ac482e8d4f201565be8aed |
| institution | DOAJ |
| issn | 2799-8010 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Yeungnam University College of Medicine, Yeungnam University Institute Medical Science |
| record_format | Article |
| series | Journal of Yeungnam Medical Science |
| spelling | doaj-art-4dc25dbfe0ac482e8d4f201565be8aed2025-08-20T03:05:24ZengYeungnam University College of Medicine, Yeungnam University Institute Medical ScienceJournal of Yeungnam Medical Science2799-80102025-02-014210.12701/jyms.2025.42.262888Magnesium as an adjunct to nimodipine in subarachnoid hemorrhage: a meta-analysisRiva Satya Radiansyah0Yuri Pamungkas1Ilham Ikhtiar2 Faculty of Medicine and Health, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia Faculty of Medicine and Health, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia Department of Neurology, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, IndonesiaBackground Subarachnoid hemorrhage (SAH) is a devastating neurological condition with high morbidity and mortality rates. Although nimodipine is widely used in the management of SAH, the potential benefits of magnesium as adjunct therapy remain unclear. This meta-analysis aimed to evaluate the efficacy and safety of combining magnesium with nimodipine for the management of SAH. Methods A comprehensive literature search was conducted using PubMed, ScienceDirect, Google Scholar, and the Cochrane Library. Randomized controlled trials and prospective cohort studies comparing magnesium plus nimodipine versus nimodipine alone in patients with SAH were included. Key outcomes included cerebral vasospasm (CV), delayed cerebral ischemia (DCI), functional outcomes, mortality, and adverse events. Results Twelve studies involving 2,338 patients were included. The combination of magnesium and nimodipine significantly reduced the incidence of CV (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.29–0.95; p=0.03) and DCI (OR, 0.52; 95% CI, 0.31–0.87; p=0.01) compared to nimodipine alone. However, no significant differences were found in functional outcomes (modified Rankin Scale: OR, 0.97; p=0.75; Glasgow Outcome Scale: OR, 0.81; p=0.24), mortality (OR, 0.97; p=0.83), or secondary cerebral infarction (OR, 0.38; p=0.12). The incidence of adverse events was higher in the combination group; however, this difference was not statistically significant (OR, 3.14; p=0.33). Conclusion Adding magnesium to nimodipine therapy in patients with SAH may help reduce CV and DCI incidence but does not significantly improve functional outcomes or mortality. Further large-scale studies are needed to optimize the dosing regimens and confirm these findings.http://www.e-jyms.org/upload/pdf/jyms-2025-42-26.pdfcerebral vasospasmmagnesiummortalitynimodipinesubarachnoid hemorrhage |
| spellingShingle | Riva Satya Radiansyah Yuri Pamungkas Ilham Ikhtiar Magnesium as an adjunct to nimodipine in subarachnoid hemorrhage: a meta-analysis Journal of Yeungnam Medical Science cerebral vasospasm magnesium mortality nimodipine subarachnoid hemorrhage |
| title | Magnesium as an adjunct to nimodipine in subarachnoid hemorrhage: a meta-analysis |
| title_full | Magnesium as an adjunct to nimodipine in subarachnoid hemorrhage: a meta-analysis |
| title_fullStr | Magnesium as an adjunct to nimodipine in subarachnoid hemorrhage: a meta-analysis |
| title_full_unstemmed | Magnesium as an adjunct to nimodipine in subarachnoid hemorrhage: a meta-analysis |
| title_short | Magnesium as an adjunct to nimodipine in subarachnoid hemorrhage: a meta-analysis |
| title_sort | magnesium as an adjunct to nimodipine in subarachnoid hemorrhage a meta analysis |
| topic | cerebral vasospasm magnesium mortality nimodipine subarachnoid hemorrhage |
| url | http://www.e-jyms.org/upload/pdf/jyms-2025-42-26.pdf |
| work_keys_str_mv | AT rivasatyaradiansyah magnesiumasanadjuncttonimodipineinsubarachnoidhemorrhageametaanalysis AT yuripamungkas magnesiumasanadjuncttonimodipineinsubarachnoidhemorrhageametaanalysis AT ilhamikhtiar magnesiumasanadjuncttonimodipineinsubarachnoidhemorrhageametaanalysis |