Abstract
Introduction: Magnesium is an essential element in functioning human body. Low magnesium is associated with membrane destabilization, whereas high concentrations are membrane stabilizing and therefore, antiarrhythmic. Acute coronary syndrome comprises of ST segment elevated myocardial infarction (STEMI), non-ST segment elevated myocardial infarction (NSTEMI) and unstable angina where the blood flow to the heart is decreased. Magnesium plays important role in Sepsis and attributed to its effects on Immune System. Hypomagnesemia is commonly observed in patients admitted to Intensive Care Unit
Aim: To find the prevalence of Serum Magnesium levels with SOFA score in assessing the prognosis in Acute Coronary Syndrome patients and its associated complications.
Methodology: This is hospital-based cross-sectional study. The sample size was calculated to be 77. All patients of age more than 18 years who are diagnosed to have Acute Coronary Syndromes were included in this study after screening for the exclusion criteria. After written consent, all patients were subjected into study. Clinical presentation and demographic profile and lab parameters were assessed.
Results: In this study of 77 patients the mean age was 60 ± 10.8; age group between 51-70 had highest proportion of 57%. About 71.40% are male, while 29% are female. Chest pain observed in 100% of patients while palpitation seen in 98.7%. Highest proportion of comorbidity seen in Type 2 Diabetes 90%, followed by Systemic Hypertension at 64%. The majority of patients across most variables fall into the Normomagnesemia category. The differences in distribution of age, gender, comorbidities, Troponin I status, and ECG changes & SOFA score across the magnesium levels categories are not statistically significant, as indicated by the P values being greater than 0.05. These patients did not develop any arrhythmic complications.
Conclusion: This study showed no significant relationship between the Serum Magnesium and SOFA score and good prognosis among patients with acute coronary syndrome. However, further studies are required to increase the understanding of the association between Serum Magnesium and SOFA score in various study settings to diagnose the patient earlier and take necessary preventive measures and treatment to prevent the occurrence of complications.
Keywords: Acute coronary syndrome, Serum Magnesium, SOFA score, Normomagnesemia.
References
- Sabah Z, Wani J, Deajim M, Zomia AS, Asiri A, et al. Serum Magnesium in Patients With Acute Myocardial Infarction and Its Effect on Cardiac Complications and Mortality in Myocardial Infarction Patients. Cureus. 2023 Apr 26;15(4).
- Huijgen HJ, Soesan M, Sanders R, Mairuhu WM, Kesecioglu J, Sanders GT. Magnesium levels in critically ill patients. What should we measure? Am J Clin Pathol 2000;114(5):688–695. DOI: 10.1309
- Barnett R. Acute myocardial infarction. Lancet. (2019) 393:2580. doi: 10.1016/S0140-6736(19)31419-9.
- Valley TS, Iwashyna TJ, Cooke CR, Sinha SS, Ryan AM, Yeh RW, et al. Intensive care use and mortality among patients with ST elevation myocardial infarction: retrospective cohort study. BMJ. (2019) 365:l1927. doi: 10.1136/bmj.l1927.
- Sanders GT, Huijgen HJ, Sanders R. Magnesium in disease: a review with special emphasis on the serum ionized magnesium. Clin Chem Lab Med. (1999) 37:1011–33. doi: 10.1515/CCLM.1999.151.
- Tan L, Xu Q, Li C, Liu J, Shi R: High-normal serum magnesium and hypermagnesemia are associated with increased 30-day in-hospital mortality: a retrospective cohort study. Front Cardiovasc Med. 2021, 8:625133.
- Lal L, Murmu H. Serum Magnesium in Patients with Acute Myocardial Infarction. Int J Sci Stud 2016;4(3):167-169.
- Gonuguntla V, Talwar V, Krishna B, Srinivasan G. Correlation of Serum Magnesium Levels with Clinical Outcome: A Prospective Observational Study in Critically Ill Patients Admitted to a Tertiary Care ICU in India. Indian Journal of Critical Care Medicine: 2023 May;27(5):342.
- Sotos‐Prieto M, Baylin A, Campos H, Qi L, Mattei J. Lifestyle cardiovascular risk score, genetic risk score, and myocardial infarction in Hispanic/Latino adults living in Costa Journal of the American Heart Association. 2016 Dec 20;5(12):e004067.
- Hasan MZ, Nahar K, Sharif JU, Paul SC, Thakur AK, Mahmud A, Siddique NA, Islam MR, Paul Serum Magnesium Level and It's Relation in Predicting Adverse In-Hospital Outcome in Patients with First Attack of Myocardial Infarction. Mymensingh Medical Journal: MMJ. 2023 Jan 1;32(1):65-72.
- Upala S, Jaruvongvanich V, Wijarnpreecha K, Sanguankeo A. Hypomagnesemia and mortality in patients admitted to intensive care unit: a systematic review and meta-analysis. QJM: An International Journal of Medicine. 2016 Jul 1;109(7):453-9.
- Chen M, et al,The influence of serum magnesium level on the prognosis of critically ill patients 2015 Mar.
- Singh A, Museedi AS, Grossman SA. Acute Coronary Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Mar 21].
- Kumar A, Cannon CP. Acute Coronary Syndromes: Diagnosis and Management, Part I. Mayo Clin Proc. 2009 Oct;84(10):917–38.
- Sreeniwas Kumar A, Sinha N. Cardiovascular disease in India: A 360-degree overview. Med J Armed Forces India. 2020 Jan;76(1)
- Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction. Circulation. (2004) 110:588–636. doi: 10.1161/01.CIR.0000134791.68010.
Corresponding Author
Dr Vidhya B
Post Graduate Resident, Department of Internal Medicine
Sri Manakula Vinayagar Medical College and Hospital – Puducherry
DOI: https://dx.doi.org/10.18535/jmscr/v12i08.13
