Serum magnesium concentration may predict no-reflow phenomenon in primary angioplasty for ST-elevation myocardial
Eser Açıkgöz1, Sadık Kadri Açıkgöz2, Gökhan Çiçek3
1Abdurrahman Yurtaslan Oncology Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
Insights
Low serum magnesium levels are linked to the no-reflow phenomenon in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. This finding suggests magnesium
Area of Science:
- Cardiology
- Interventional Cardiology
- Biochemistry
Background:
- The no-reflow phenomenon is a critical complication following percutaneous coronary intervention (PCI).
- Magnesium influences platelet aggregation and endothelial function, potentially impacting no-reflow.
- Understanding factors predicting no-reflow is crucial for improving patient outcomes after myocardial infarction.
Purpose of the Study:
- To investigate the association between admission serum magnesium levels and the occurrence of angiographic no-reflow.
- To identify serum magnesium concentration as a potential predictor of no-reflow in ST-elevation myocardial infarction (STEMI) patients.
Main Methods:
- A cohort of 2,248 consecutive STEMI patients undergoing primary PCI was analyzed.
- No-reflow was defined as TIMI flow rate ≤ 2 after infarct artery recanalization.
- Serum magnesium levels were measured on admission; logistic regression and ROC analysis were employed.
Main Results:
- No-reflow occurred in 17.1% of patients (386/2,248).
- Patients with no-reflow had significantly lower serum magnesium concentrations (1.87 ± 0.25 vs. 2.07 ± 0.33 mg/dL, p<0.001).
- Serum magnesium concentration, age, and stent length were independent predictors of no-reflow.
Conclusions:
- Admission serum magnesium concentration is significantly associated with the no-reflow phenomenon in STEMI patients undergoing primary PCI.
- Lower magnesium levels may contribute to the development of no-reflow.
- Magnesium status could be a target for preventing no-reflow complications.
Abstract:
No-reflow phenomenon is a serious complication of percutaneous coronary intervention. Magnesium may play a role in pathogenesis of no-reflow phenomenon since it interacts with processes like platelet inhibition and endothelial-dependent vasodilatation. Relationship of serum magnesium concentration at admission and angiographic no-reflow phenomenon in ST elevation myocardial infarction patients undergoing primary percutaneous coronary intervention is investigated in the present study. A total of 2.248 consecutive patients with ST elevation myocardial infarction who underwent primary percutaneous coronary intervention were analyzed. After reopening of the infarct related artery, a TIMI flow rate ≤ 2 was defined as no-reflow. No-reflow phenomenon developed in 386 (17.1 %) patients. Serum magnesium concentration was significantly lower in no-reflow group (1.87 ± 0.25 vs. 2.07 ± 0.33 mg/dL, p<0.001). ROC curve analysis showed that Mg at a cut-point of 1.92 has 71.4% sensitivity and 75.2% specificity in detecting no-reflow phenomenon. In multivariate logistic regression analysis, age, serum magnesium concentration, and stent length were found as independent predictors of no-reflow phenomenon. Serum magnesium concentration is associated with no-reflow phenomenon in ST elevation myocardial infarction patients who underwent primary PCI.
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