Serum Magnesium Levels and In-Hospital Mortality in Acute Myocardial Infarction

Shafiq, Ali; Goyal, Abhinav; Jones, Philip G.; Sahil, Suman; Hoffman, Mark A.; Qintar, Mohammed; Buchanan, Donna M.; Kosiborod, Mikhail; Arnold, Suzanne V.

doi:10.1016/j.jacc.2017.03.579

Cited by 16 publications

(14 citation statements)

References 6 publications

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“…A large retrospective cohort study involving 10,806 patients with acute myocardial infraction found a U-shaped relationship between the most recent magnesium levels and mortality. Lowest mortality was seen with serum magnesium levels of ∼0.74 to 0.83 mmol/L [ 131 ]. However, several RCTs have shown conflicting results regarding the role of intravenous magnesium administration in reducing mortality in patients with acute myocardial infarction [ 132 ].…”

Section: Hypo- and Hypermagnesemia In Cardiovascular Healthmentioning

confidence: 99%

Magnesium and Human Health: Perspectives and Research Directions

Alawi

Majoni

Falhammar

2018

International Journal of Endocrinology

321

223

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Magnesium is the fourth most abundant cation in the body. It has several functions in the human body including its role as a cofactor for more than 300 enzymatic reactions. Several studies have shown that hypomagnesemia is a common electrolyte derangement in clinical setting especially in patients admitted to intensive care unit where it has been found to be associated with increase mortality and hospital stay. Hypomagnesemia can be caused by a wide range of inherited and acquired diseases. It can also be a side effect of several medications. Many studies have reported that reduced levels of magnesium are associated with a wide range of chronic diseases. Magnesium can play important therapeutic and preventive role in several conditions such as diabetes, osteoporosis, bronchial asthma, preeclampsia, migraine, and cardiovascular diseases. This review is aimed at comprehensively collating the current available published evidence and clinical correlates of magnesium disorders.

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Section: Hypo- and Hypermagnesemia In Cardiovascular Healthmentioning

confidence: 99%

Magnesium and Human Health: Perspectives and Research Directions

Alawi

Majoni

Falhammar

2018

International Journal of Endocrinology

321

223

View full text Add to dashboard Cite

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“…The mechanisms of intracellular magnesium regulating cardiac physiology were widely studied; therefore, many small sample-size and single-center studies provided contradictory conclusions about the relationship between serum magnesium and AMI mortality ( 24 , 25 ). Most researches indicated the inverse correlation between admission serum magnesium levels and the risk of mortality ( 26 – 28 ). However, other studies showed that admission serum magnesium level could not predict the hospital outcome of patients with AMI ( 25 , 29 ).…”

Section: Discussionmentioning

confidence: 99%

“…Actually, an increasing number of clinical studies questioned the benefit of magnesium supplementation and the secure range of serum magnesium for AMI patients. A study from the Journal of the American College of Cardiology showed that the optimal range of magnesium in patients with AMI should be lower than what is currently recommended by AMI guidelines ( 26 ). Moreover, the ISIS-4 trial (Fourth International Study of Infarct Survival) included a large group of 58,050 patients with suspected AMI but did not show a positive effect of magnesium supplementation ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

High-Normal Serum Magnesium and Hypermagnesemia Are Associated With Increased 30-Day In-Hospital Mortality: A Retrospective Cohort Study

Tan

et al. 2021

Front. Cardiovasc. Med.

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Background: Magnesium, the fourth most abundant mineral nutrient in our body, plays a critical role in regulating ion channels and energy generation, intracardiac conduction, and myocardial contraction. In this study, we assessed the association of admission serum magnesium level with all-cause in-hospital mortality in critically ill patients with acute myocardial infarction (AMI).Methods: Clinical data were extracted from the eICU Collaborative Research Database (eICU-CRD). Only the data for the first intensive care unit (ICU) admission of each patient were used, and baseline data were extracted within 24 h after ICU admission. Logistic regression, Cox regression, and subgroup analyses were conducted to determine the relationship between admission serum magnesium level and 30-day in-hospital mortality in ICU patients with AMI.Results: A total of 9,005 eligible patients were included. In the logistic regression analysis, serum magnesium at 2.2 to ≤2.4 and >2.4 mg/dl levels were both significant predictors of all-cause in-hospital mortality in AMI patients. Moreover, serum magnesium of 2.2 to ≤2.4 mg/dl showed higher risk of in-hospital mortality than magnesium of >2.4 mg/dl (adjusted odds ratio, 1.63 vs. 1.39). The Cox regression analysis yielded similar results (adjusted hazard ratio, 1.36 vs. 1.25).Conclusions: High-normal serum magnesium and hypermagnesemia may be useful and easier predictors for 30-day in-hospital mortality in critically ill patients with AMI.

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“…In HF patients, hypomagnesemia is frequently observed (with a reported 7%–38% range), together with other electrolyte abnormalities such as hypocalcemia [ 5 , 9 ]. Maintaining a normal Mg level with Mg supplementation plays a protective role on HF survival and on all-cause mortality [ 191 ]. Gottlieb et al reported that HF patients with low Mg levels have a two-year survival rate of 42% vs. 61% for patients with normal Mg levels [ 39 ].…”

Section: Mg Supplementation As a Therapeutic Treatment For Cardiommentioning

confidence: 99%

“…Mg shows protective effects on arrhythmias in MI. Low serum Mg is associated with increased risk and mortality of acute MI [ 191 , 214 ], and Mg deficiency, in turn, aggravates MI by inducing mitochondrial dysfunction and increasing oxidative stress-induced ischemic injury [ 96 , 110 , 215 , 216 ]. In Mg-treated patients, there is ~20% reduction in infarct size [ 217 ], ~24%–50% decreased mortality [ 20 , 48 , 192 , 214 , 218 , 219 ], decreased rates of arrhythmias after infarction [ 48 , 217 , 218 , 219 , 220 ], increased ejection fraction [ 221 ], and improved myocardial contractile function [ 193 ].…”

Section: Mg Supplementation As a Therapeutic Treatment For Cardiommentioning

confidence: 99%

Magnesium, Oxidative Stress, Inflammation, and Cardiovascular Disease

Liu

Dudley

2020

Antioxidants

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Hypomagnesemia is commonly observed in heart failure, diabetes mellitus, hypertension, and cardiovascular diseases. Low serum magnesium (Mg) is a predictor for cardiovascular and all-cause mortality and treating Mg deficiency may help prevent cardiovascular disease. In this review, we discuss the possible mechanisms by which Mg deficiency plays detrimental roles in cardiovascular diseases and review the results of clinical trials of Mg supplementation for heart failure, arrhythmias and other cardiovascular diseases.

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Serum Magnesium Levels and In-Hospital Mortality in Acute Myocardial Infarction

Cited by 16 publications

References 6 publications

Magnesium and Human Health: Perspectives and Research Directions

Magnesium and Human Health: Perspectives and Research Directions

High-Normal Serum Magnesium and Hypermagnesemia Are Associated With Increased 30-Day In-Hospital Mortality: A Retrospective Cohort Study

Magnesium, Oxidative Stress, Inflammation, and Cardiovascular Disease

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