title: Low serum magnesium predicts neurological events in patients with advanced atherosclerosis.
abstract: 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.
authors.affiliation: Department of Angiology, Vienna General Hospital, Medical School, Vienna, Austria.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Amighi
authors.forename: Schila
authors.initials: S
authors.lastname: Sabeti
authors.forename: Oliver
authors.initials: O
authors.lastname: Schlager
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Mlekusch
authors.forename: Markus
authors.initials: M
authors.lastname: Exner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lalouschek
authors.forename: Ramazanali
authors.initials: R
authors.lastname: Ahmadi
authors.forename: Erich
authors.initials: E
authors.lastname: Minar
authors.forename: Martin
authors.initials: M
authors.lastname: Schillinger
mesh_terms: 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
chemical_list: D008274:Magnesium