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

4 november 2026 uppdaterad av: 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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

260

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

  • Namn: Justin Ezekowitz, MD
  • Telefonnummer: 780-492-0712
  • E-post: jae2@ualberta.ca

Studera Kontakt Backup

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Övrig
  • Tilldelning: Randomiserad
  • Interventionsmodell: Sekventiell tilldelning
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.

Experimentell: 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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Feasibility of trial conduct
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Recruitment Rate
Tidsram: Up to 24 months (recruitment period)

Number of participants enrolled per site per month.

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

Proportion of eligible patients who provide consent.

Up to 30 days
Intervention Fidelity
Tidsram: During index hospitalization

Adherence to assigned strategy and separation between randomized groups.

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

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

Up to 30 days

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
All-Cause Mortality
Tidsram: Up to 30 days

All-cause death following randomization.

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

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

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

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

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

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

Up to 30 days
Symptomatic Hypotension
Tidsram: During index hospitalization

Occurrence of symptomatic hypotension during the index hospitalization.

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

Serious adverse events occurring during the index hospitalization.

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

Admission to the intensive care unit during the index hospitalization.

Up to 30 days
Length of Hospital Stay
Tidsram: 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)
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Utredare

  • Huvudutredare: Arnav Agarwal, MD, University of Alberta

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Användbara länkar

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 november 2026

Primärt slutförande (Beräknad)

1 november 2028

Avslutad studie (Beräknad)

1 maj 2029

Studieregistreringsdatum

Först inskickad

8 september 2026

Först inskickad som uppfyllde QC-kriterierna

24 oktober 2026

Första postat (Faktisk)

30 oktober 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

9 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

4 november 2026

Senast verifierad

1 november 2026

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • MAG-01

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