Corbi Graziamaria, Acanfora Domenico, Iannuzzi Gian Luca, Longobardi Giancarlo, Cacciatore Francesco, Furgi Giuseppe, Filippelli Amelia, Rengo Giuseppe, Leosco Dario, Ferrara Nicola
Rehabilitative Cardiology Unit of S. Maugeri Foundation, Scientific Institute of Telese/Campoli, IRCCS, Telese Terme, Italy.
Rejuvenation Res. 2008 Feb;11(1):129-38. doi: 10.1089/rej.2007.0583.
The aim of this study was to evaluate the role of magnesium levels on 3-year survival in the elderly with congestive heart failure (CHF) admitted to the Rehabilitative Cardiology Unit of S. Maugeri Foundation Scientific Institute of Telese/Campoli. All elderly patients > or = 65 years old with a diagnosis of CHF underwent clinical and instrumental examination, and their demographics, co-morbidity, and in-hospital and 3-year mortality rates were recorded. Hypomagnesemia was found in 4.8%, normomagnesemia in 67.5%, and hypermagnesemia in 27.8% of subjects. The hypomagnesemic group was excluded for numerical exiguity; the analysis was performed on a total of 199 elderly patients. Hypermagnesemia was found in 29.1% and normomagnesemia in 70.9%. At the univariate analysis no differences were found in hypermagnesemia in respect to normomagnesemia group, except for slightly higher levels of creatininemia (1.35 +/- 0.61 vs. 1.13 +/- 0.55 mg/dL, respectively; p < 0.02), greater disability (lost ADL, 2.69 +/- 1.57 vs. 2.15 +/- 1.56, respectively; p < 0.05), more mortality for CHF (32.6 vs. 48.3%; p < 0.05), and higher antacid and laxative use (82.7 vs. 24.8%, respectively; p < 0.0001). Patients with higher magnesium showed less probability to survive at a 3-year follow-up than did patients with lower levels (17.32 +/- 15.93 vs. 22.46 +/- 16.16 months; p < 0.05), and this finding remained significant in the multivariate analysis after adjusting for some confounders. Finally hypermagnesemia should also be considered in the absence of pre-existing renal failure clinical evidence because of its negative prognostic value, especially in elderly patients with CHF. The shown relationship between hypermagnesemia and laxative/antacid use should induce physicians to pay more attention to abuse of these drugs.
本研究旨在评估镁水平对入住泰莱斯/坎波利圣毛杰里基金会科学研究所康复心脏病科的老年充血性心力衰竭（CHF）患者3年生存率的作用。所有年龄≥65岁且诊断为CHF的老年患者均接受了临床和器械检查，并记录了他们的人口统计学资料、合并症以及住院和3年死亡率。研究对象中，4.8%为低镁血症，67.5%为正常镁血症，27.8%为高镁血症。低镁血症组因数量过少被排除；对总共199例老年患者进行了分析。结果发现高镁血症患者占29.1%，正常镁血症患者占70.9%。单因素分析显示，与正常镁血症组相比高镁血症组并无差异，但血肌酐水平略高（分别为1.35±0.61与1.13±0.55mg/dL；p<0.02）、残疾程度更高（丧失日常生活活动能力，分别为2.69±1.57与2.15±1.56；p<0.05）、CHF死亡率更高（32.6%与48.3%；p<0.05），以及抗酸剂和泻药使用频率更高（分别为82.7%与24.8%；p<0.0001）。镁水平较高的患者在3年随访期内存活的可能性低于镁水平较低的患者（分别为17.32±15.93与22.46±16.16个月；p<0.05），在调整了一些混杂因素后的多因素分析中，这一发现仍然具有显著性。最后，由于高镁血症具有不良预后价值，即使在没有既往肾衰竭临床证据的情况下也应予以考虑，尤其是在老年CHF患者中。高镁血症与泻药/抗酸剂使用之间的关系表明，医生应更加关注这些药物的滥用情况。
