Changes in serum magnesium concentration after use of a proton pump inhibitor in patients undergoing percutaneous coronary intervention.
BACKGROUND
Although cross-sectional studies have suggested a relationship between proton pump inhibitor (PPI) use and hypomagnesemia, no large-scale cohort study has been conducted to date. Here, we examined the changes in serum magnesium levels in response to PPI use. We hypothesized that PPI use might change the serum magnesium concentration.


METHODS
Of the 2,892 patients hospitalized for percutaneous coronary intervention between January 2007 and May 2012, 1,076 patients with normal baseline (1.6-2.5 mg/dL) and follow-up serum magnesium concentrations were enrolled. These patients were divided into two groups: the PPI group and the control group.


RESULTS
The mean follow-up period was 9.51 ± 2.94 months. The incidence of hypomagnesemia (< 1.6 mg/dL) was 0.4% (3/834) in the PPI group and 0.4% (1/242) in the control group (P = 0.904). The change in magnesium levels did not differ between the two groups, and this result was maintained in the analysis of covariance after adjusting for confounding factors (P = 0.381). Moreover, magnesium levels did not significantly differ between the long-term (duration of use ≥ 12 months, n = 71) and short-term PPI groups (duration of use < 12 months, n = 763), and the control group (n = 242; P = 0.620). The effect of PPI use on change in serum magnesium concentration was affected by the use of multiple diuretics (-0.01 ± 0.25 mg/dL; P = 0.025), although a single diuretic use with PPI did not alter the change in magnesium level (0.12 ± 0.27 mg/dL).


CONCLUSIONS
Changes in magnesium levels might be subtle after PPI use in patients with normal baseline magnesium values.
Department of Internal medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Sang-Ho
SH
Park
Department of Internal medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Sun-Hyo
SH
Lee
Biostatistical Consulting Unit, Soonchunhyang University Medical Center, Seoul, Korea.
Ji-Sung
JS
Lee
Department of Internal medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Won-Yong
WY
Shin
Department of Internal medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Hyo-Wook
HW
Gil
Department of Internal medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Jong-Oh
JO
Yang
Department of Internal medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Eun-Young
EY
Lee
Department of Internal medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Sae-Yong
SY
Hong
Diuretics; Magnesium; Proton pump inhibitor