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The Role of Magnesium Levels in the Progression of Contrast-Induced Nephropathy in Patients With STEMI Undergoing
Ayşe İrem Demirtola1, Anar Mammadli2, Gökhan Çiçek1
1Department of Cardiology, University of Health Sciences Ankara City Hospital, Ankara, Turkey.
Insights
Low magnesium levels are linked to contrast-induced nephropathy (CIN) in ST-Elevation Myocardial Infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). Magnesium <2.03 mg/dL is an independent risk factor for CIN development.
Area of Science:
- Cardiology
- Nephrology
- Biochemistry
Background:
- Contrast-induced nephropathy (CIN) is a significant complication after primary percutaneous coronary intervention (pPCI) in ST-Elevation Myocardial Infarction (STEMI) patients.
- Magnesium (Mg²⁺) deficiency is linked to renal dysfunction and cardiovascular diseases, but its role in CIN is not well understood.
Purpose of the Study:
- To investigate the association between serum Mg²⁺ levels and the incidence of CIN in STEMI patients undergoing pPCI.
- To identify Mg²⁺ levels as a potential independent predictor for CIN.
Main Methods:
- Retrospective study of 2306 consecutive STEMI patients undergoing pPCI.
- Serum Mg²⁺ levels measured on admission.
- Logistic regression and Receiver Operating Characteristic (ROC) analysis used to assess CIN risk.
Main Results:
- 30% of patients developed CIN post-pPCI.
- Patients with CIN had significantly lower serum Mg²⁺ levels (P < .001).
- Independent predictors of CIN included Mg²⁺ <2.03 mg/dL, age >68 years, LVEF <49%, and TIMI flow grade <2.
- ROC analysis identified Mg²⁺ cutoff of 2.03 mg/dL (AUC: 0.711, sensitivity: 69%, specificity: 68%).
Conclusions:
- Low serum Mg²⁺ levels are significantly correlated with CIN in STEMI patients undergoing pPCI.
- Serum Mg²⁺ <2.03 mg/dL is identified as an independent risk factor for CIN.
- This finding may inform strategies for CIN prevention in high-risk patients.
Abstract:
Contrast-induced nephropathy (CIN) poses a significant risk following primary percutaneous coronary intervention (pPCI) in patients with ST-Elevation Myocardial Infarction (STEMI). Magnesium (Mg²⁺) deficiency has been associated with renal dysfunction and cardiovascular diseases, yet its role in CIN development remains unclear. This study represents the first investigation exploring the relationship between Mg²⁺ levels and CIN in this context.We conducted a retrospective study involving 2306 consecutive STEMI patients undergoing pPCI. Serum Mg²⁺ levels were measured on admission. Logistic regression and Receiver Operating Characteristic (ROC) analysis were employed to assess the association between Mg²⁺ levels and CIN development. Of the enrolled patients, 691 (30%) developed CIN post-pPCI. Mg²⁺ levels were significantly lower in the CIN group (P < .001). Multivariate analysis identified Mg²⁺ <2.03 mg/dL, age >68 years, left ventricular Ejection Fraction (EF) <49%, and post-procedure Thrombolysis In Myocardial Infarction (TIMI) flow grade <2 as independent predictors of CIN. ROC analysis revealed an Mg²⁺ cutoff of 2.03 mg/dL, Area Under the Curve (AUC): 0.711, sensitivity: 69%, specificity: 68%). Our study demonstrates a significant correlation between low Mg²⁺ levels and CIN in STEMI patients undergoing pPCI, highlighting Mg²⁺ <2.03 mg/dL as an independent risk factor for CIN.
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