title: Acute decrease in serum magnesium level after ischemic stroke may not predict decrease in neurologic function.
abstract: BACKGROUND
  Higher serum levels of magnesium (Mg2+) may contribute to improved outcome following ischemic stroke, and this may be related to vessel recanalization. Patients with low or normal serum magnesium levels during the acute phase of ischemic stroke may be more susceptible to neurologic deterioration (ND) and worse outcomes.
  
  
  METHODS
  All patients who presented to our center within 48 hours of acute ischemic stroke (July 2008 to December 2010) were retrospectively identified. Patient demographics, laboratory values, and multiple outcome measures, including ND, were compared across admission serum Mg2+ groups and change in Mg2+ from baseline to 24-hour groups.
  
  
  RESULTS
  Three hundred thirteen patients met inclusion criteria (mean age: 64.8 years, 42.2% female, 64.0% black). Mg2+ groups at baseline were not predictive of poor functional outcome, death, or discharge disposition. Patients whose serum Mg2+ decreased during the first 24 hours of admission were also not at greater odds of ND or poor outcome measures compared with patients with unchanging or increasing Mg2+ levels.
  
  
  CONCLUSIONS
  Our results suggest that patients who have low Mg2+ at baseline or a reduction in Mg2+ 24 hours after admission are not at a higher risk of experiencing ND or poor short-term outcome. Ongoing prospective interventional trials will determine if hyperacute aggressive magnesium replacement affords neuroprotection in stroke.
authors.affiliation: Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, Louisiana.
authors.forename: James E
authors.initials: JE
authors.lastname: Siegler
authors.forename: Amelia K
authors.initials: AK
authors.lastname: Boehme
authors.forename: Karen C
authors.initials: KC
authors.lastname: Albright
authors.forename: Sami
authors.initials: S
authors.lastname: Bdeir
authors.forename: Anoop K
authors.initials: AK
authors.lastname: Kar
authors.forename: Leann
authors.initials: L
authors.lastname: Myers
authors.forename: T Mark
authors.initials: TM
authors.lastname: Beasley
authors.forename: Sheryl
authors.initials: S
authors.lastname: Martin-Schild
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D015536:Down-Regulation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009420:Nervous System / Q000503:physiopathology*; D009460:Neurologic Examination; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D013997:Time Factors
chemical_list: D015415:Biomarkers; D008274:Magnesium
keywords: Stroke; ischemia; magnesium; neurologic deterioration; neuroprotection