Effect of magnesium bisglycinate following coronary syndrome in young adults: a retrospective cohort study of self-reported sleep quality, anxiety symptoms, and depressive symptoms

Anxiety, depression, and poor sleep are common after acute coronary syndrome (ACS) and adversely affect prognosis, yet treatment options are limited. Oral magnesium bisglycinate improves sleep and mood in non-cardiac populations but has not been studied following ACS. We investigated whether post-discharge magnesium bisglycinate use is associated with improvement in self-reported sleep quality and anxiety and depressive symptom scores. In this single-centre retrospective cohort, 120 patients (68 magnesium, 52 comparator) were followed for three months after ACS. Magnesium bisglycinate (240 mg elemental magnesium daily) was initiated at the first post-discharge visit. The primary outcome was sleep quality (Pittsburgh Sleep Quality Index, PSQI); anxiety (Beck Anxiety Inventory, BAI) and depression (Beck Depression Inventory, BDI) were secondary outcomes, assessed with serum magnesium at baseline and three months. Baseline characteristics were comparable. At three months, the magnesium group showed greater improvement in self-reported sleep quality (PSQI: 5.2 ± 2.6 vs 7.3 ± 3.1; p < 0.001), anxiety (BAI: 12.1 ± 4.9 vs 15.8 ± 5.3; p < 0.001), and depressive symptoms (BDI: 8.3 ± 4.7 vs 11.2 ± 5.5; p = 0.003), with Cohen's d = 0.57-0.74. Serum magnesium did not differ between groups at either time point (p = 0.55 and p = 0.20), and the associations persisted after multivariable adjustment and in sensitivity models including baseline serum magnesium, renal function, and medications affecting magnesium balance. Post- discharge magnesium bisglycinate use was associated with greater improvement in self-reported sleep, anxiety, and depressive symptom scores following ACS. These hypothesis-generating findings, limited by residual confounding and healthy-user bias, require confirmation in an adequately powered randomized controlled trial.