Association of Serum Magnesium on Mortality in Patients Admitted to the Intensive Cardiac Care Unit

Naksuk, Niyada; Hu, Tiffany; Krittanawong, Chayakrit; Thongprayoon, Charat; Sharma, Sunita; Park, Sun-Hee; Rosenbaum, Andrew; Gaba, Prakriti; Killu, Ammar M.; Sugrue, Alan; Peeraphatdit, Thoetchai; Herasevich, Vitaly; Bell, Malcolm R.; Brady, Peter A.; Kapa, Suraj; Asirvatham, Samuel J.

doi:10.1016/j.amjmed.2016.08.033

Cited by 51 publications

(52 citation statements)

References 32 publications

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“…50,51) However, no association has been reported between serum magnesium levels and QTc interval. 29) Fourth, we could not analyze our data stratified by sex because of the small sample size. Nevertheless, we assessed the relationship between the ADPN level and clinical characteristics including ECG parameters and the odds ratio for QTc prolongation in ADPN tertiles according to the sex-specific tertiles of ADPN.…”

Section: Discussionmentioning

confidence: 99%

“…The QTc intervals were calculated using Bazett's formula (QTc = QT / RR). 28,29) In brief, the ECG tracings were blinded to the participants' demographics and first analyzed by two independent cardiologists and a senior supervising cardiologist. Inter-reader discrepancies were resolved by direct comparison and adjudicated by the supervising cardiologist.…”

Section: Study Populationmentioning

confidence: 99%

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Elevated Plasma Adiponectin Levels Are Associated with Abnormal Corrected QT Interval in Patients with Stable Angina

Chang

Hsu

et al. 2020

Int. Heart J.

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Low-circulating levels of adiponectin (ADPN) are associated with obesity, diabetes mellitus, and coronary artery disease. On the contrary, some studies have demonstrated a link between relatively high levels of plasma ADPN and heart failure, atrial fibrillation, and adverse outcome. However, little is known about the relationship between ADPN level and prolonged QT interval. The aim of this study was to investigate the association between plasma ADPN levels and prolonged QT interval in patients with stable angina. In this retrospective study, because the diverse disease severity and condition of the study population may have affected the results, we chose individuals with stable angina. Plasma ADPN concentrations were measured using enzyme-linked immunosorbent assays. A 12-lead ECG recording was obtained from each patient. We enrolled 479 stable-angina patients. Patients with an abnormal corrected QT (QTc) interval had higher median plasma ADPN levels than those with normal QTc intervals. Age-and sex-adjusted ADPN levels were positively associated with heart rate, QTc interval, left ventricular mass index, and creatinine but negatively associated with left ventricular ejection fraction, waist circumference, current smoking, total cholesterol, triglycerides, low-density lipoprotein cholesterol, albumin, and estimated glomerular filtration rate. A multiple logistic regression analysis revealed ADPN as an independent association factor for abnormal QTc interval. Increasing concentrations of sex-specific ADPN were independently and significantly associated with abnormal QTc interval, even after full adjustment of known biomarkers. Our results indicate that ADPN may play a role in the pathogenesis of abnormal QTc interval in patients with stable angina.

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Section: Discussionmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Elevated Plasma Adiponectin Levels Are Associated with Abnormal Corrected QT Interval in Patients with Stable Angina

Chang

Hsu

et al. 2020

Int. Heart J.

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“…Pickham et al showed that hyperglycaemia is linked with QTc prolongation. 54 Moreover, whether albumin is associated with the expression of cardiac ion channels, cardiomyocyte electrophysiology, and the underlying mechanism are still unclear. 49 In our study, we also found that the QTc interval was negatively associated with eGFR and albumin level.…”

Section: Discussionmentioning

confidence: 99%

“…Although previous studies reported that hypomagnesaemia has been associated with atrial and ventricular arrhythmias and low serum magnesium could therefore also be a risk factor for sudden cardiac death, 52,53 no association was found between serum magnesium levels and QTc interval. 54 Moreover, whether albumin is associated with the expression of cardiac ion channels, cardiomyocyte electrophysiology, and the underlying mechanism are still unclear. Further investigations are warranted to elucidate these issues.…”

Section: Despite the Strong Evidence Showing The Effect Of Serum Albumentioning

confidence: 99%

Serum albumin level and abnormal corrected QT interval in patients with coronary artery disease and chronic kidney disease

et al. 2018

Internal Medicine Journal

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“…Likewise, studies examining associations between plasma zinc and number of organ failures, or associations between low plasma levels of magnesium, phosphate or zinc and mortality have been contradictory . In addition, observational studies examining hypermagnesaemia and hyperphosphataemia have typically reported the inverse association of increased mortality as compared with lower plasma levels …”

Section: Introductionmentioning

confidence: 99%

Effects of magnesium, phosphate and zinc supplementation in ICU patients—Protocol for a systematic review

Vesterlund

Thomsen²,

Møller

et al. 2019

Acta Anaesthesiol Scand

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Background: Depletion of the trace elements magnesium, phosphate and zinc is common in patients admitted to the intensive care unit (ICU). Observational studies have suggested worse outcome in patients with hypomagnesaemia, hypophosphataemia or hypozincaemia, but also inverse associations with worse outcome with too high serum levels. However, it is unclear whether data from randomised clinical trials (RCTs) confirm this. Accordingly, we plan to assess the balance between benefits and harms of supplementation as compared with placebo or no supplementation in adult ICU patients. Methods:We will conduct a systematic review of RCTs with meta-analysis and trial sequential analysis in accordance with the Cochrane Handbook for Systematic Reviews of Interventions, the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach. We will assess the effects of any supplementation with magnesium, phosphate or zinc vs. placebo or no treatment in adult ICU patients. We will systematically search the Cochrane CENTRAL, Embase, PubMed, and for unpublished trials: ClinicalTrials.gov, the EU clinical TrialsRegister and the WHO International Clinical Trials Registry Platform. The primary outcomes will be days alive without mechanical ventilation and overall mortality.Secondary outcomes include use for mechanical ventilation, tachy-arrhythmias, use of vasopressors, length of hospital stay and use of renal replacement therapy. Discussion:The benefits and harms of supplementation therapy with magnesium, phosphate and zinc in general ICU patients are unknown. This outlined systematic review will provide data on the evidence, on which future recommendations for supplementation may be founded.

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Association of Serum Magnesium on Mortality in Patients Admitted to the Intensive Cardiac Care Unit

Abstract: This retrospective study unexpectedly observed no association between serum magnesium levels and QTc interval or sudden cardiac death. However, serum magnesium ≥2.4 mg/dL was an independent predictor of increased hospital morality among CCU patients.

Cited by 51 publications

References 32 publications

Elevated Plasma Adiponectin Levels Are Associated with Abnormal Corrected QT Interval in Patients with Stable Angina

Elevated Plasma Adiponectin Levels Are Associated with Abnormal Corrected QT Interval in Patients with Stable Angina

Serum albumin level and abnormal corrected QT interval in patients with coronary artery disease and chronic kidney disease

Effects of magnesium, phosphate and zinc supplementation in ICU patients—Protocol for a systematic review

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