Key result
Initial serum magnesium level was an independent predictor of electrocardiographic no-reflow (OR 0.01; 95% CI 0.01-0.12; P=0.004) and long-term mortality in patients with STEMI.
Why the study?
Do initial serum magnesium levels predict electrocardiographic no-reflow and long-term mortality in patients with STEMI undergoing pPCI?
Observational (n=111)
Do initial serum magnesium levels predict electrocardiographic no-reflow and long-term mortality in patients with STEMI undergoing pPCI?
Lower initial serum magnesium levels are associated with a higher risk of electrocardiographic no-reflow and long-term mortality in STEMI patients undergoing primary PCI.
May refine STEMI risk stratification; hypothesis-generating for magnesium supplementation trials.
AIM: The aim of this study is to examine the relationship between initial magnesium (Mg) levels, electrocardiographic no-reflow, and long-term mortality in patients who underwent primary percutaneous coronary intervention (pPCI) due to ST-segment elevation myocardial infarction (STEMI). METHODS: A total of 111 patients with pPCI participated in the study. Magnesium and high-sensitive C-reactive protein (hs-CRP) were measured. The sum of ST-segment elevation was measured immediately before and 60 minutes after the restoration of coronary flow. The difference between the 2 measurements was taken as the amount of ST-segment resolution and defined as sum of ST-segment resolution (∑STR). The ∑STR <50% was determined as electrocardiographic sign of no-reflow phenomenon. After the patients were discharged, they were followed up for major adverse cardiac events for up to 51 months after discharge. RESULTS: Forty patients in the no-reflow group and 71 patients in the normal-flow group were included in the study. Magnesium value ≤1.87 mg/dL initially measured had 77% sensitivity and 59% specificity in predicting no-reflow on receiver operating characteristic curve analysis. In multivariate analyses, Mg (odds ratio [OR]: 0.01, <95% confidence interval [CI]: 0.01-0.12; P = .004), hs-CRP (OR: 1.06, <95% CI: 1.00-1.14; P = .05), left anterior descending artery lesion (OR: 6.66, <95% CI: 1.45-3.05; P = .01), and reperfusion time (OR: 1.01, <95% CI: 1.00-1.01; P = .03) were still independent predictors of electrocardiographic no-reflow, and only Mg (OR: 0.08, <95% CI: 0.01-1.03; P = .05) was still an independent predictor of long-term mortality. CONCLUSION: Serum Mg level is an independent predictor of electrocardiographic no-reflow and long-term mortality in patients with STEMI.
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Yüksel et al. (2016) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=111). Initial magnesium (Mg) levels vs. Normal flow group / higher Mg levels was evaluated on Electrocardiographic no-reflow (∑STR <50%) (OR 0.01, 95% CI 0.01-0.12, p=.004). Initial serum magnesium level was an independent predictor of electrocardiographic no-reflow (OR 0.01; 95% CI 0.01-0.12; P=0.004) and long-term mortality in patients with STEMI.
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