血清镁与非 ST 段抬高型心肌梗死患者的长期生存相关。

Serum Magnesium Is Associated with Long-Term Survival of Non-ST-Elevation Myocardial Infarction Patients.

机构信息

The Leviev Cardiothoracic & Vascular Center, Sheba Medical Center, Ramat Gan 5262504, Israel.

The Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.

出版信息

Nutrients. 2023 Oct 9;15(19):4299. doi: 10.3390/nu15194299.

DOI:10.3390/nu15194299

PMID:37836583

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10574643/

Abstract

BACKGROUND

Low serum magnesium (sMg) is associated with cardiovascular risk factors and atherosclerotic disease.

OBJECTIVE

To evaluate the association between sMg levels on admission and clinical outcomes in hospitalized non-ST-elevation myocardial infarction (NSTEMI) patients.

METHODS

A retrospective analysis of all patients admitted to a single tertiary center with a primary diagnosis of NSTEMI. Patients with advanced chronic kidney disease were excluded. Clinical data were collected and compared between lower sMg quartile patients (Q1; sMg < 1.9 mg/dL) and all other patients (Q2-Q4; sMg ≥ 1.9 mg/dL).

RESULTS

The study cohort included 4552 patients (70% male, median age 69 [IQR 59-79]) who were followed for a median of 4.4 (IQR 2.4-6.6) years. The median sMg level in the low sMg group was 1.7 (1.6-1.8) and 2.0 (2.0-2.2) mg/dL in the normal/high sMg group. The low sMg group was older (mean of 72 vs. 67 years), less likely to be male (64% vs. 72%), and had higher rates of comorbidities, including diabetes, hypertension, and atrial fibrillation (59% vs. 29%, 92% vs. 85%, and 6% vs. 5%; < 0.05 for all). Kaplan-Meier survival analysis demonstrated significantly higher cumulative death probability at 4 years in the low sMg group (34% vs. 22%; log rank <0.001). In a multivariable analysis model adjusted for sex, significant comorbidities, coronary interventions during the hospitalization, and renal function, the low sMg group exhibited an independent 24% increased risk of death during follow up (95% CI 1.11-1.39; < 0.001).

CONCLUSIONS

Low sMg is independently associated with higher risk of long-term mortality among patients recovering from an NSTEMI event.

摘要

背景

血清镁（sMg）水平较低与心血管危险因素和动脉粥样硬化性疾病相关。

目的

评估入院时 sMg 水平与住院非 ST 段抬高型心肌梗死（NSTEMI）患者临床结局的相关性。

方法

对单一三级中心因 NSTEMI 入院的所有患者进行回顾性分析。排除晚期慢性肾脏病患者。收集并比较 sMg 四分位较低组（Q1；sMg＜1.9mg/dL）和所有其他患者（Q2-Q4；sMg≥1.9mg/dL）的临床数据。

结果

研究队列包括 4552 例患者（70%为男性，中位年龄 69[IQR 59-79]岁），中位随访时间为 4.4（IQR 2.4-6.6）年。低 sMg 组的中位 sMg 水平为 1.7（1.6-1.8）mg/dL，正常/高 sMg 组为 2.0（2.0-2.2）mg/dL。低 sMg 组年龄较大（平均 72 岁 vs. 67 岁），男性比例较低（64% vs. 72%），合并症发生率较高，包括糖尿病、高血压和心房颤动（59% vs. 29%、92% vs. 85%和 6% vs. 5%；所有 P 值均＜0.05）。Kaplan-Meier 生存分析显示，低 sMg 组 4 年时的累积死亡率明显较高（34% vs. 22%；log rank＜0.001）。在校正性别、显著合并症、住院期间的冠状动脉介入治疗和肾功能后，多变量分析模型显示低 sMg 组在随访期间死亡风险增加 24%（95%CI 1.11-1.39；P＜0.001）。