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Serum magnesium levels and risk of coronary artery disease: Mendelian randomisation study
Susanna C Larsson1, Stephen Burgess2,3, Karl Michaëlsson4
1Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden. susanna.larsson@ki.se.
Insights
Higher serum magnesium levels are genetically linked to a lower risk of coronary artery disease (CAD). This Mendelian randomization study suggests a potential causal relationship, supporting further research into magnesium supplementation for CAD prevention.
Area of Science:
- Genetics and Cardiovascular Disease Epidemiology
- Nutritional Genomics
- Biomarker Discovery
Background:
- Observational studies indicate an inverse relationship between serum magnesium and cardiovascular disease risk.
- The causal nature of this association remains unconfirmed.
- Coronary artery disease (CAD) is a major global health concern.
Purpose of the Study:
- To investigate the potential causal association between serum magnesium levels and coronary artery disease (CAD) risk.
- To utilize Mendelian randomization to infer causality from observational data.
Main Methods:
- A Mendelian randomization analysis was performed using summary-level data.
- Data originated from the CARDIoGRAMplusC4D consortium's genome-wide association meta-analysis.
- Six single-nucleotide polymorphisms robustly associated with serum magnesium served as instrumental variables.
Main Results:
- A genetic predisposition to higher serum magnesium levels was inversely associated with CAD risk.
- Each 0.1-mmol/L increase in genetically predicted serum magnesium corresponded to an 12-17% reduced odds of CAD.
- Findings were consistent across multiple sensitivity analyses, reinforcing the robustness of the results.
Conclusions:
- This genetic study provides evidence supporting a causal inverse association between serum magnesium levels and CAD risk.
- Further research, including randomized controlled trials, is warranted to confirm if magnesium supplementation reduces CAD risk.
- Clinical trials may be particularly beneficial in populations at higher risk of hypomagnesaemia.
Background:
Observational studies have shown that serum magnesium levels are inversely associated with risk of cardiovascular disease, but whether this association is causal is unknown. We conducted a Mendelian randomisation study to investigate whether serum magnesium levels may be causally associated with coronary artery disease (CAD).
Methods:
This Mendelian randomisation analysis is based on summary-level data from the CARDIoGRAMplusC4D consortium's 1000 Genomes-based genome-wide association meta-analysis of 48 studies with a total of 60,801 CAD cases and 123,504 non-cases. Six single-nucleotide polymorphisms associated with serum magnesium levels at genome-wide significance were used as instrumental variables.
Results:
A genetic predisposition to higher serum magnesium levels was inversely associated with CAD. In conventional Mendelian randomisation analysis, the odds ratio of CAD was 0.88 (95% confidence interval [CI] 0.78 to 0.99; P = 0.03) per 0.1-mmol/L (about 1 standard deviation) increase in genetically predicted serum magnesium levels. Results were consistent in sensitivity analyses using the weighted median and heterogeneity-penalised model averaging methods, with odds ratios of 0.84 (95% CI 0.72 to 0.98; P = 0.03) and 0.83 (95% CI 0.71 to 0.96; P = 0.02), respectively.
Conclusions:
This study based on genetics provides evidence that serum magnesium levels are inversely associated with risk of CAD. Randomised controlled trials elucidating whether magnesium supplementation lowers the risk of CAD, preferably in a setting at higher risk of hypomagnesaemia, are warranted.
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