Low serum magnesium predicts neurological events in patients with advanced atherosclerosis.
OBJECTIVE
Magnesium (Mg) deficiency is thought to be a risk factor for cerebrovascular atherosclerosis and complications. We investigated the prognostic impact of Mg serum levels with respect to the occurrence of neurological events in patients with advanced atherosclerosis.


METHODS
We prospectively studied 323 patients with symptomatic peripheral artery disease and intermittent claudication (197 men; median age, 68 years). Serum Mg was determined, and patients were followed for a median of 20 months (interquartile range, 12 to 25 months) for the occurrence of neurological events, defined as ischemic stroke and/or carotid revascularization (carotid endarterectomy or carotid stenting). Multivariate Cox proportional hazards analysis was applied to assess the association of serum Mg (in tertiles) and neurological events.


RESULTS
Neurological events occurred in 35 patients (11%) (15 patients with stroke, 13 with carotid revascularization, and 7 with stroke and subsequent revascularization). Compared with patients in the highest tertile of Mg serum levels (>0.84 mmol/L), patients with Mg serum values <0.76 mmol/L (lowest tertile) exhibited a 3.29-fold increased adjusted risk (95% CI, 1.34 to 7.90; P=0.009) for neurological events, but patients with Mg serum values of 0.76 mmol/L to 0.84 mmol/L (middle tertile) had no increased risk (adjusted hazard ratio, 1.10; 95% CI, 0.35 to 3.33; P=0.88). Mg serum levels were not associated with all-cause mortality (P=0.87) or coronary events (P=0.67) during follow-up.


CONCLUSIONS
Low Mg serum levels indicate an increased risk for neurological events in patients with symptomatic peripheral artery disease, favoring Mg substitution therapy in those patients with advanced atherosclerosis.
Amighi
Jasmin
J
Department of Angiology, Vienna General Hospital, Medical School, Vienna, Austria.
Sabeti
Schila
S
Schlager
Oliver
O
Mlekusch
Wolfgang
W
Exner
Markus
M
Lalouschek
Wolfgang
W
Ahmadi
Ramazanali
R
Minar
Erich
E
Schillinger
Martin
M
D000368:Aged; D001161:Arteriosclerosis / Q000097:blood* / Q000453:epidemiology; D002545:Brain Ischemia / Q000097:blood / Q000453:epidemiology; D002340:Carotid Artery Diseases / Q000097:blood / Q000453:epidemiology / Q000601:surgery; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000097:blood / Q000453:epidemiology; D008274:Magnesium / Q000097:blood*; D008275:Magnesium Deficiency / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D016491:Peripheral Vascular Diseases / Q000097:blood* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data; D020521:Stroke / Q000097:blood* / Q000453:epidemiology
D008274:Magnesium