The association of serum magnesium and mortality outcomes in heart failure patients

Angkananard, Teeranan; Anothaisintawee, Thunyarat; Eursiriwan, Sudarat; Gorelik, Oleg; McEvoy, Mark; Attia, John; Thakkinstian, Ammarin

doi:10.1097/md.0000000000005406

Cited by 50 publications

(34 citation statements)

References 39 publications

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“…Generally, low levels of plasma magnesium are considered to be one of the risk factors for the development of heart failure 76–78 . Hypomagnesaemia may therefore be an additional risk factor involved in heart failure exacerbation in patients with hypocalcaemic cardiomyopathy.…”

Section: Discussionmentioning

confidence: 99%

Hypocalcaemic cardiomyopathy: a description of two cases and a literature review

et al. 2020

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Hypocalcaemic cardiomyopathy is a rare form of dilated cardiomyopathy. The authors here present two cases in which symptomatic dilated cardiomyopathy was the result of severe hypocalcaemia. First, we report about a 26-year-old woman with primary hypoparathyroidism and then about a 74-year-old man with secondary hypoparathyroidism following a thyroidectomy. In both cases, the left ventricular systolic function improved after calcium supplementation. In the first case, a lack of compliance led to a repeated decrease of both serum calcium level and left ventricular systolic function. The authors also present a comprehensive summary of all cases of hypocalcaemic dilated cardiomyopathy that have been described in literature to date. The mean age of the affected patients was 48.3 years, of which 62% were female patients. The most common causes of hypocalcaemic cardiomyopathy are primary hypoparathyroidism (50%) and post-thyroidectomy hypoparathyroidism (26%). In the post-thyroidectomy subgroup, the median time for the development of hypocalcaemic cardiomyopathy is 10 years (range: 1.5 months to 36 years). Hypocalcaemic cardiomyopathy leads to heart failure with reduced ejection fraction in 87% of patients. Generally, the most common complications of hypoparathyroidism and/or hypocalcaemia are cerebral calcifications, cognitive deficit, and cataracts. Once calcium supplementation is administered, the disease has a good prognosis and, in most individuals, a significant improvement (21%) or even normalization (74%) of the left ventricular systolic function occurs.

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Section: Discussionmentioning

confidence: 99%

Hypocalcaemic cardiomyopathy: a description of two cases and a literature review

et al. 2020

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“…Finally, in a recent systematic review and meta-analysis of studies conducted in HF patients, hypermagnesemia with serum [Mg 2+ ] ≥1.05 mmol/L was associated with an increased risk of CVD death and all-cause death, but this was not observed for hypomagnesemia [ 74 ]. However, these findings were limited to elderly patients with chronic HF who had reduced left ventricular systolic function.…”

Section: Circulating Magnesium and Cardiovascular Diseasementioning

confidence: 99%

Dietary Magnesium and Cardiovascular Disease: A Review with Emphasis in Epidemiological Studies

et al. 2018

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Magnesium (Mg) is an essential dietary element for humans involved in key biological processes. A growing body of evidence from epidemiological studies, randomized controlled trials (RCTs) and meta-analyses have indicated inverse associations between Mg intake and cardiovascular diseases (CVD). The present review aims to summarize recent scientific evidence on the topic, with a focus on data from epidemiological studies assessing the associations between Mg intake and major cardiovascular (CV) risk factors and CVD. We also aimed to review current literature on circulating Mg and CVD, as well as potential biological processes underlying these observations. We concluded that high Mg intake is associated with lower risk of major CV risk factors (mainly metabolic syndrome, diabetes and hypertension), stroke and total CVD. Higher levels of circulating Mg are associated with lower risk of CVD, mainly ischemic heart disease and coronary heart disease. Further, RCTs and prospective studies would help to clarify whether Mg intake and Mg circulating levels may also protect against other CVDs and CVD death.

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“…An increase in serum magnesium is commonly seen in patients with low GFR (acute or chronic), following treatment with magnesium-containing medications, excessive tissue breakdown (such as sepsis, tumour lysis syndrome and burn) 28 29. An increase in serum magnesium may result in flaccid muscle paralysis, suppressed respiration and apnoea, especially among those with concomitant hypocalcaemia 10 30–33. Altogether, patients who had change in serum magnesium either downward or upward trend carried higher mortality risk compared with those with stable magnesium levels throughout hospitalisation.…”

Section: Discussionmentioning

confidence: 99%

“…Abnormal serum magnesium level has been shown to be associated with an increased risk of cardiovascular and all-cause mortality 2 4–10. Studies have demonstrated that dysmagnesaemia is associated with increased left ventricular mass,2 septic shock,3 acute kidney injury (AKI)11 and respiratory failure 12.…”

Section: Introductionmentioning

confidence: 99%

Association of serum magnesium level change with in-hospital mortality

Cheungpasitporn

Hansrivijit

Thirunavukkarasu

et al. 2020

BMJ EBM

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The objective of this study was to assess the association of in-hospital mortality risk based on change in serum magnesium levels in hospitalised patients. All adult patients admitted to our hospital from years 2009 to 2013 with at least two serum magnesium measurements during hospitalisation were included. Serum magnesium change, defined as the absolute difference between the highest and lowest serum magnesium, was categorised into six groups: 0–0.2, 0.3–0.4, 0.5–0.6, 0.7–0.8, 0.9–1.0, ≥1.1 mg/dL. In-hospital mortality was the outcome of interest. Logistic regression was used to assess the association between serum magnesium change and in-hospital mortality, using serum magnesium change of 0.0–0.2 mg/dL as the reference group. A total of 42 141 patients, with the median serum magnesium change during hospital stay of 0.3 (IQR 0.2–0.6) mg/dL, were studied. In-hospital mortality based on serum magnesium change of 0–0.2, 0.3–0.4, 0.5–0.6, 0.7–0.8, 0.9–1.0, ≥1.1 mg/dL was 1.3%, 2.3%, 3.1%, 5.0%, 6.5%, and 8.8%, respectively (p<0.001). After adjustment for potential confounders, increased serum magnesium change was significantly associated with higher in-hospital mortality with adjusted OR of 1.39 (95% 1.14–1.69) in serum magnesium change of 0.3–0.4, 1.48 (95% CI 1.21 to 1.81) in 0.5–0.6, 1.89 (95% CI 1.53 to 2.34) in 0.7–0.8, 1.85 (95% CI 1.45 to 2.37) in 0.9–1.0 and 1.89 (95% CI 1.48 to 2.41) in ≥1.1 mg/dL when compared with serum magnesium change group of 0–0.2 mg/dL. Increased in-hospital mortality was associated with both downward and upward trends of serum magnesium change during hospitalisation. The greater extent of change in serum magnesium levels was progressively associated with increased in-hospital mortality

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The association of serum magnesium and mortality outcomes in heart failure patients

Abstract: Supplemental Digital Content is available in the text

Cited by 50 publications

References 39 publications

Hypocalcaemic cardiomyopathy: a description of two cases and a literature review

Hypocalcaemic cardiomyopathy: a description of two cases and a literature review

Dietary Magnesium and Cardiovascular Disease: A Review with Emphasis in Epidemiological Studies

Association of serum magnesium level change with in-hospital mortality

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