Association between short-term changes in serum magnesium and in-hospital mortality following acute myocardial
Abstract:
The association between short-term changes in serum magnesium level and risk of in-hospital mortality was investigated in patients with acute myocardial infarction (AMI). In this retrospective cohort study, data of 2,716 patients with AMI were extracted from the Medical Information Mart for Intensive Care (MIMIC-III and MIMIC-IV) database for 2001-2012. Univariate and multivariate Cox proportional hazards models were used to explore the association between serum magnesium level and short-term change and in-hospital mortality in patients with AMI. In addition, subgroups according to age, gender, Sequential Organ Failure Assessment (SOFA) score, and Simplified Acute Physiology Score (SAPS-II) were also analysed. In total, 504 (18.6%) patients died in hospital. After adjusting for covariates, all AMI patients with high magnesium levels at ICU admission (HR=1.03, 95% CI: 0.83-1.27) or 48 hours after ICU admission (all p<0.05), or those demonstrating a change in magnesium level within the first 48 hours of ICU stay (all p<0.05) were shown to have a high risk of in-hospital mortality. Moreover, this correlation was retained irrespective of age, gender, SOFA score, and SAPS-II (all p<0.05). Serum magnesium levels at different time points after ICU admission and change in serum magnesium level during the first 48 hours were associated with in-hospital mortality in patients with AMI, indicating that clinical attention should be paid to short-term changes in serum magnesium levels regarding treatment adjustment, which may further reduce the risk of mortality.
Insights
Short-term changes in serum magnesium levels are linked to increased in-hospital mortality risk in acute myocardial infarction (AMI) patients. Monitoring magnesium is crucial for adjusting treatment and reducing mortality in AMI.
Area of Science:
- Cardiology
- Critical Care Medicine
- Biochemistry
Background:
- Acute myocardial infarction (AMI) is a leading cause of mortality worldwide.
- Serum magnesium levels play a critical role in cardiac function and patient outcomes.
- Understanding the dynamic changes in magnesium levels during critical illness is essential.
Purpose of the Study:
- To investigate the association between short-term changes in serum magnesium levels and in-hospital mortality in AMI patients.
- To determine if magnesium levels at ICU admission or within 48 hours impact mortality.
- To explore the predictive value of magnesium level fluctuations for mortality risk.
Main Methods:
- Retrospective cohort study utilizing data from the MIMIC-III and MIMIC-IV databases (2001-2012).
- Included 2,716 patients diagnosed with AMI.
- Employed univariate and multivariate Cox proportional hazards models to analyze associations, adjusting for covariates and subgroup analyses (age, gender, SOFA, SAPS-II).
Main Results:
- A total of 504 (18.6%) patients died during hospitalization.
- Elevated serum magnesium levels at ICU admission and 48 hours post-admission were associated with a higher risk of in-hospital mortality (p<0.05).
- Significant changes in serum magnesium levels within the first 48 hours of ICU stay also correlated with increased mortality risk (p<0.05), irrespective of patient demographics or severity scores.
Conclusions:
- Short-term variations and levels of serum magnesium are significant predictors of in-hospital mortality in AMI patients.
- Clinical monitoring and potential adjustment of magnesium levels within the first 48 hours of ICU admission may be a viable strategy to mitigate mortality risk.
- These findings highlight the importance of dynamic magnesium monitoring in critical care for AMI management.
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