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Routine Magnesium Testing and Supplementation in Acute Heart Failure (MAG-HF) (MAG-HF)

4 november 2026 bijgewerkt door: University of Alberta

Routine Magnesium Testing and Supplementation in Acute Heart Failure (MAG-HF): a Pragmatic Randomized Controlled Trial

This study is an investigator-initiated, pragmatic, randomized controlled feasibility trial evaluating two strategies for magnesium management in adults hospitalized with acute heart failure (AHF). Participants will be randomized to either a strategy of no routine magnesium testing or intravenous (IV) supplementation, or a strategy of routine magnesium testing with IV supplementation according to standard of care.

The primary objective is to determine the feasibility of conducting a definitive, multi-centre trial by assessing recruitment, consent, intervention adherence, and completeness of follow-up over a 30-day period. We plan to recruit 260 participants across two centres over approximately 24 months.

In addition to feasibility outcomes, clinical event rates will be evaluated to inform the design of a future definitive trial. These include all-cause death, all-cause hospital readmission, and heart failure readmission within 30 days of randomization, capturing events both during the index hospitalization and after discharge. In-hospital outcomes will include arrhythmia, symptomatic hypotension, serious adverse events, intensive care unit admission, and length of stay. Health-related quality of life will be assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ) at protocol-defined timepoints.

This trial is conducted within the HEART platform, a master protocol designed to evaluate multiple interventions in heart failure using a shared infrastructure.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Acute heart failure (AHF) is a common cause of hospitalization and is associated with high rates of morbidity and rehospitalization. Magnesium abnormalities are frequently observed in hospitalized patients, and intravenous magnesium supplementation is commonly used in clinical practice despite limited evidence supporting routine testing and replacement strategies in this population. Variation in practice patterns exists, and the clinical impact of routine magnesium testing and supplementation in AHF remains uncertain.

The MAG-HF trial is an investigator-initiated, pragmatic, randomized controlled feasibility trial designed to evaluate the feasibility of conducting a definitive multi-centre trial comparing two strategies for magnesium management in adults hospitalized with AHF. Participants will be randomized to either a strategy of no routine magnesium testing or intravenous (IV) supplementation, or to a strategy of routine magnesium testing with IV supplementation according to standard of care. The study is conducted within the HEART platform, which provides a shared infrastructure to evaluate multiple interventions in heart failure.

The primary objective is to assess feasibility, including recruitment rates, consent rates, intervention adherence, and completeness of follow-up over 30 days. The study will enroll 260 participants across two centres over approximately 24 months.

In addition to feasibility outcomes, the trial will evaluate clinical event rates to inform the design of a future definitive study. Clinical outcomes assessed within 30 days of randomization will include all-cause death, all-cause hospital readmission, and heart failure readmission, capturing events both during the index hospitalization and after discharge. In-hospital outcomes during the index admission will include clinically significant arrhythmias, symptomatic hypotension, serious adverse events, intensive care unit admission, and length of hospital stay. Health-related quality of life will be assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ) at protocol-defined timepoints.

This feasibility trial is not powered to assess treatment effectiveness. Instead, the results will be used to inform the design, sample size, and operational considerations of a future definitive randomized controlled trial evaluating magnesium management strategies in AHF.

Studietype

Ingrijpend

Inschrijving (Geschat)

260

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

  • Naam: Justin Ezekowitz, MD
  • Telefoonnummer: 780-492-0712
  • E-mail: jae2@ualberta.ca

Studie Contact Back-up

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Adults aged ≥ 18 years admitted to hospital with a clinical diagnosis of suspected or confirmed AHF and with an elevated serum natriuretic peptide level on presentation will be eligible.
  • Elevated natriuretic peptide levels are defined as a B-type natriuretic peptide (BNP) level of 400 pg/ml or higher; or a N-terminal pro-B-type natriuretic peptide (NT-proBNP) level of 1000 pg/mL or higher.

Exclusion Criteria:

  • Adults with an admission diagnosis other than AHF, presence of a pre-specified indication for magnesium supplementation on presentation (specified below), or having other medical conditions which, in the investigator's judgement, would make participation unsafe will be ineligible.
  • Torsades de pointes
  • Severe (< 3.0) or recurrent hypokalemia (< 3.5 x 2+ readings)
  • Pre-eclampsia or eclampsia
  • Severe asthma exacerbations
  • Hypomagnesemia (< 0.70 mmol/L) within seven days of randomization. (Clarification Magnesium testing is not required to confirm hypomagnesemia).
  • Concurrent enrolment will not automatically exclude a participant. Co-enrolment will be permitted only where allowed by both domain protocols and where the interventions and operational requirements are judged compatible. No washout is required after completion of a non-conflicting domain intervention.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Ander
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Sequentiële toewijzing
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: No Routine Magnesium Testing or Supplementation

Participants assigned to a strategy of no routine magnesium testing and no routine intravenous magnesium supplementation during the index hospitalization

A strategy in which no routine serum magnesium testing is performed and no routine intravenous magnesium supplementation is administered during the index hospitalization.

Experimenteel: Routine Magnesium Testing and Supplementation

Participants assigned to a strategy of routine magnesium testing with intravenous magnesium supplementation administered according to standard of care.

A strategy in which serum magnesium is measured and intravenous magnesium supplementation is administered according to standard of care during the index hospitalization.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Feasibility of trial conduct
Tijdsspanne: Up to 30 days

Feasibility will be assessed by recruitment rate, consent rate, intervention fidelity, and completeness of follow-up and outcome ascertainment at 30 days.

Up to 30 days

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Recruitment Rate
Tijdsspanne: Up to 24 months (recruitment period)

Number of participants enrolled per site per month.

Up to 24 months (recruitment period)
Consent Rate
Tijdsspanne: Up to 30 days

Proportion of eligible patients who provide consent.

Up to 30 days
Intervention Fidelity
Tijdsspanne: During index hospitalization

Adherence to assigned strategy and separation between randomized groups.

During index hospitalization
Completeness of Follow-up
Tijdsspanne: Up to 30 days

Proportion of participants with complete follow-up and outcome ascertainment.

Up to 30 days

Andere uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
All-Cause Mortality
Tijdsspanne: Up to 30 days

All-cause death following randomization.

Up to 30 days
All-Cause Hospital Readmission
Tijdsspanne: Up to 30 days

Hospital readmission for any cause following discharge from the index hospitalization.

Up to 30 days
Heart Failure Readmission
Tijdsspanne: Up to 30 days

Hospital readmission due to heart failure following discharge from the index hospitalization.

Up to 30 days
Clinically Significant Arrhythmia
Tijdsspanne: Up to 30 days

Incident new or worsened clinically significant supraventricular or ventricular arrhythmia during the index hospitalization.

Up to 30 days
Symptomatic Hypotension
Tijdsspanne: During index hospitalization

Occurrence of symptomatic hypotension during the index hospitalization.

During index hospitalization
Serious Adverse Events (SAEs)
Tijdsspanne: Up to 30 days

Serious adverse events occurring during the index hospitalization.

Up to 30 days
Intensive Care Unit (ICU) Admission
Tijdsspanne: Up to 30 days

Admission to the intensive care unit during the index hospitalization.

Up to 30 days
Length of Hospital Stay
Tijdsspanne: Up to 30 days

Duration of the index hospitalization in days.

Up to 30 days
Change in Kansas City Cardiomyopathy Questionnaire Total Symptom Score (KCCQ-TSS)
Tijdsspanne: Up to 30 days

Change in Kansas City Cardiomyopathy Questionnaire (KCCQ) Total Symptom Score from baseline to Day 5 comparing treatment groups. The Kansas City Cardiomyopathy Questionnaire Total Symptom Score (KCCQ-TSS) ranges from 0 to 100, where higher scores indicate fewer heart failure symptoms and better health status, and lower scores indicate more severe symptoms and worse health status.

Up to 30 days

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Onderzoekers

  • Hoofdonderzoeker: Arnav Agarwal, MD, University of Alberta

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Nuttige links

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 november 2026

Primaire voltooiing (Geschat)

1 november 2028

Studie voltooiing (Geschat)

1 mei 2029

Studieregistratiedata

Eerst ingediend

8 september 2026

Eerst ingediend dat voldeed aan de QC-criteria

24 oktober 2026

Eerst geplaatst (Werkelijk)

30 oktober 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

9 november 2026

Laatste update ingediend die voldeed aan QC-criteria

4 november 2026

Laatst geverifieerd

1 november 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • MAG-01

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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