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Low serum magnesium and cardiovascular mortality in chronic heart failure: a propensity-matched study

Chris Adamopoulos1, Bertram Pitt, Xuemei Sui

  • 1Papageorgiou General Hospital, Thessaloniki, Greece.

International Journal of Cardiology
|August 2, 2008
PubMed

Insights

Low serum magnesium levels in chronic heart failure patients are linked to higher cardiovascular mortality. This study found a significant association between low magnesium and increased risk of death from heart conditions.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Internal Medicine

Background:

  • Low serum magnesium is a known risk factor for fatal ventricular arrhythmias.
  • The long-term impact of low magnesium on mortality and morbidity in chronic heart failure (CHF) patients remains under-investigated.

Purpose of the Study:

  • To investigate the association between low serum magnesium levels and long-term mortality and hospitalization in patients with chronic systolic and diastolic heart failure.

Main Methods:

  • A cohort of 1569 CHF patients from the Digitalis Investigation Group trial with available serum magnesium data at one month was analyzed.
  • Patients were categorized into normal (>2 mEq/L) and low (<=2 mEq/L) magnesium groups.
  • Propensity score matching was used to create balanced groups (560 patients each) for Cox regression analysis of mortality and hospitalization over a mean 36-month follow-up.

Main Results:

  • Low serum magnesium was associated with a trend towards increased all-cause mortality (Hazard Ratio: 1.23, p=0.089).
  • A significant increase in cardiovascular mortality was observed in the low magnesium group (Hazard Ratio: 1.38, p=0.024).
  • No significant association was found for all-cause or cardiovascular hospitalizations.

Conclusions:

  • In ambulatory CHF patients, serum magnesium levels of 2 mEq/L or less are associated with increased cardiovascular mortality.
  • This association persists even after propensity score matching, indicating a robust link.
  • Low magnesium did not show a significant association with cardiovascular hospitalization in this cohort.
Abstract

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