Niyada Naksuk1, Tiffany Hu2, Chayakrit Krittanawong3, Charat Thongprayoon4, Sunita Sharma5, Jae Yoon Park1, Andrew N Rosenbaum6, Prakriti Gaba2, Ammar M Killu1, Alan M Sugrue6, Thoetchai Peeraphatdit7, Vitaly Herasevich8, Malcolm R Bell1, Peter A Brady1, Suraj Kapa1, Samuel J Asirvatham9. 1. Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, Minn. 2. Mayo Medical School, Mayo Clinic College of Medicine, Rochester, Minn. 3. Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, Minn; Department of Medicine, Cleveland Clinic, Ohio; CharlesMedLab, Cleveland, Ohio. 4. Department of Anesthesiology, Mayo Clinic, Rochester, Minn; Department of Internal Medicine, Mary Imogene Bassett Healthcare, Cooperstown, NY. 5. Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minn; Division of Cardiovascular Diseases, Lahey Hospital and Medical Center, Burlington, Mass. 6. Division of Cardiovascular Diseases, Lahey Hospital and Medical Center, Burlington, Mass. 7. Division of Internal Medicine, Department of Medicine Education, University of Minnesota Twin Cities, Minneapolis; Division of Gastroenterology, Department of Medicine, Mayo Clinic, Rochester, Minn. 8. Department of Anesthesiology, Mayo Clinic, Rochester, Minn. 9. Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, Minn; Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minn. Electronic address: asirvatham.samuel@mayo.edu.
Abstract
BACKGROUND: Although electrolyte disturbances may affect cardiac action potential, little is known about the association between serum magnesium and corrected QT (QTc) interval as well as clinical outcomes. METHODS: A consecutive 8498 patients admitted to the Mayo Clinic Hospital-Rochester cardiac care unit (CCU) from January 1, 2004 through December 31, 2013 with 2 or more documented serum magnesium levels, were studied to test the hypothesis that serum magnesium levels are associated with in-hospital mortality, sudden cardiac death, and QTc interval. RESULTS: Patients were 67 ± 15 years; 62.2% were male. The primary diagnoses for CCU admissions were acute myocardial infarction (50.7%) and acute decompensated heart failure (42.5%), respectively. Patients with higher magnesium levels were older, more likely male, and had lower glomerular filtration rates. After multivariate analyses adjusted for clinical characteristics including kidney disease and serum potassium, admission serum magnesium levels were not associated with QTc interval or sudden cardiac death. However, the admission magnesium levels ≥2.4 mg/dL were independently associated with an increase in mortality when compared with the reference level (2.0 to <2.2 mg/dL), having an adjusted odds ratio of 1.80 and a 95% confidence interval of 1.25-2.59. The sensitivity analysis examining the association between postadmission magnesium and analysis that excluded patients with kidney failure and those with abnormal serum potassium yielded similar results. CONCLUSION: 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.
BACKGROUND: Although electrolyte disturbances may affect cardiac action potential, little is known about the association between serum magnesium and corrected QT (QTc) interval as well as clinical outcomes. METHODS: A consecutive 8498 patients admitted to the Mayo Clinic Hospital-Rochester cardiac care unit (CCU) from January 1, 2004 through December 31, 2013 with 2 or more documented serum magnesium levels, were studied to test the hypothesis that serum magnesium levels are associated with in-hospital mortality, sudden cardiac death, and QTc interval. RESULTS:Patients were 67 ± 15 years; 62.2% were male. The primary diagnoses for CCU admissions were acute myocardial infarction (50.7%) and acute decompensated heart failure (42.5%), respectively. Patients with higher magnesium levels were older, more likely male, and had lower glomerular filtration rates. After multivariate analyses adjusted for clinical characteristics including kidney disease and serum potassium, admission serum magnesium levels were not associated with QTc interval or sudden cardiac death. However, the admission magnesium levels ≥2.4 mg/dL were independently associated with an increase in mortality when compared with the reference level (2.0 to <2.2 mg/dL), having an adjusted odds ratio of 1.80 and a 95% confidence interval of 1.25-2.59. The sensitivity analysis examining the association between postadmission magnesium and analysis that excluded patients with kidney failure and those with abnormal serum potassium yielded similar results. CONCLUSION: 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.
Authors: Murray M Pollack; James M Chamberlain; Anita K Patel; Julia A Heneghan; Eduardo A Trujillo Rivera; Dongkyu Kim; James E Bost Journal: Pediatr Crit Care Med Date: 2021-02-01 Impact factor: 3.971
Authors: Juan R Muñoz-Castañeda; María V Pendón-Ruiz de Mier; Mariano Rodríguez; María E Rodríguez-Ortiz Journal: Int J Mol Sci Date: 2018-02-27 Impact factor: 5.923
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